Active NPI
Pankti Madalia, RDH
- Dental Hygienist
- Chino Hills, CA
National Provider Identifier
1790220689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 30686
- Practice address
- 16011 Butterfield Ranch Rd
Apt 226
Chino Hills, CA 91709-7455 - Phone
- (908) 400-8460
- NPI assigned
- Dec 30, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 30686 | CA | Primary |
Addresses
Primary practice location
16011 Butterfield Ranch Rd
Apt 226
Chino Hills, CA 91709-7455
Mailing address
16011 Butterfield Ranch Rd
Apt 226
Chino Hills, CA 91709-7455
Phone (908) 400-8460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30686 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30686 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1790220689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16011 BUTTERFIELD RANCH RD",
"address_2": "APT 226",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917097455",
"telephone_number": "908-400-8460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16011 BUTTERFIELD RANCH RD",
"address_2": "APT 226",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917097455",
"telephone_number": "908-400-8460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADALIA",
"first_name": "PANKTI",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-30",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "30686",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30686",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chino Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.