Lisa Nicole Malkiewich, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02681400 Issued in NJ

Practice address

821 Tennent Rd
Manalapan, NJ 07726-8250

Phone

(732) 536-2600

NPI assigned

Mar 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgetown Dental Associates, L.L.C.

  • General Practice Dentistry
  • Manalapan, NJ
  • NPI 1083712343
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1669904694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LIVINGSTON ST APT 2",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901510",
            "telephone_number": "732-881-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 TENNENT RD",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077268250",
            "telephone_number": "732-536-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Miln St",
            "address_purpose": "LOCATION",
            "city": "Cranford",
            "state": "NJ",
            "postal_code": "070162141",
            "country_code": "US",
            "telephone_number": "908-272-0787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "99 Beauvoir Ave",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079013533",
            "country_code": "US",
            "telephone_number": "908-522-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALKIEWICH",
        "first_name": "LISA",
        "middle_name": "NICOLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02681400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lina Magaziner, LCSW
• Amrita Duttraj Mahimkar
• Chhaya Nanu Maisuria, PSY.D.
• Mark Maliaros, MS ED
• Bernard Thomas Malik III, MAC, L.AC
• John Sami Mamoun, D.M.D., F.A.G.D.
• Manalapan Anesthesia and Pain Management LLC
• Manalapan Chiropractic Center
• Manalapan Dental Spa LLC
• Manalapan Family Dental, LLC

• General Practice Dentistry in Manalapan, NJ
• Providers in Manalapan, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.