Individual provider Active NPI

Albert Malakov, DDS

  • General Practice Dentistry
  • Elmhurst, NY
National Provider Identifier
1710058094
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046977-1 Issued in NY
Practice address
9123 Queens Blvd Ste B
Elmhurst, NY 11373-5559
Phone
(718) 205-2055
Fax
(718) 205-2355
NPI assigned
Nov 10, 2006
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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 046977-1 NY Primary

Addresses

Primary practice location

9123 Queens Blvd Ste B
Elmhurst, NY 11373-5559

Mailing address

11223 68TH Ave
Forest Hills, NY 11375-2937
Phone (718) 997-8288

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
046977-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tina Malakova Dental Services P.C. CurrentSince Nov 17, 2019 Accepting new patients
Love My Smile Dental PC PastSince Nov 17, 2019 Accepting new patients
Steinway Family Dental Center Past Accepting new patients

Locations

9123 Queens Blvd
Ste B
Elmhurst, NY 11373
Phone (718) 205-2055

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1710058094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11223 68TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752937",
            "telephone_number": "718-997-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 QUEENS BLVD STE B",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735559",
            "telephone_number": "718-205-2055",
            "fax_number": "718-205-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKOV",
        "first_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046977-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.