Malek Fansa D.D.S., LLC.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010260A Issued in IN

Legal business name

MALEK FANSA D.D.S., LLC.

Practice address

9620 E 59TH St
Indianapolis, IN 46216-1020

Phone

(317) 545-6545

NPI assigned

Dec 20, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Malek Fansa, D.D.S.

Title

Dentist/Owner

Phone

(317) 545-6545

Specialties & licenses 1

Addresses

Other names 1

• Gentle Family Dentistry at Fort Ben Harrison Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Esme Rose Patterson, DDS

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1477247195
  NPD (past)
• Michael A Rice, DDS

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1942254800
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1619412103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13119 MAYWICK DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9620 E 59TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462161020",
            "telephone_number": "317-545-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALEK FANSA D.D.S., LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-20",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "FANSA",
        "authorized_official_first_name": "MALEK",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "317-545-6545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010260A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Family Dentistry at Fort Ben Harrison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andriana Maree Maldonado, DDS
• Kelli Maldonado, PTA
• Olga Yolanda Maldonado, DDS
• Zachary Malecki, ATC, CSCS
• Caitlin Alyssa Maled, PHYSICIAN ASSISTANT
• Elizabeth C Malek-Maiorano, RPH
• Marissa Malen, MD
• Eugenia C Malenkos, D.P.M.
• James William Malenkos, M.D.
• Justin Scott Malenkos, M.D.

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.