Individual provider Active NPI

Kyle Matthew Maloney, DDS

  • General Practice Dentistry
  • Granada Hills, CA
National Provider Identifier
1649042763
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109601 Issued in CA
Practice address
16837 Tulsa St
Granada Hills, CA 91344-5039
Phone
(614) 746-4423
NPI assigned
Oct 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 109601 CA Primary

Addresses

Primary practice location

16837 Tulsa St
Granada Hills, CA 91344-5039

Mailing address

16837 Tulsa St
Granada Hills, CA 91344-5039
Phone (614) 746-4423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109601CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1649042763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16837 TULSA ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445039",
            "telephone_number": "614-746-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16837 TULSA ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445039",
            "telephone_number": "614-746-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.