Individual provider Active NPI

Mahrou Malekan, DMD

  • Dentist
  • Northridge, CA
National Provider Identifier
1992418222
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS107728 Issued in CA
Practice address
8540 Reseda Blvd Ste 101
Northridge, CA 91324-6144
Phone
(818) 370-2620
NPI assigned
Jan 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS107728 CA Primary

Addresses

Primary practice location

8540 Reseda Blvd Ste 101
Northridge, CA 91324-6144

Mailing address

3401 Cordova Dr
Calabasas, CA 91302-3070
Phone (818) 370-2620

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
DDS107728CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1992418222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CORDOVA DR",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023070",
            "telephone_number": "818-370-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 RESEDA BLVD STE 101",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913246144",
            "telephone_number": "818-370-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEKAN",
        "first_name": "MAHROU",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-02",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS107728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.