DR. SHIBLY D MALOUF JR. (NPI# 1053489682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053489682 |
| Entity Type | Individual |
| Full Name | DR. SHIBLY D MALOUF JR. |
| Credential | DDS |
| Practice Address |
366 Broadway Suite 100 Somerville MA 02145-2812 |
| Mailing Address |
366 Broadway Suite 100 Somerville MA 02145-2812 |
| Practice Telephone | 6176288000 |
| Practice Fax Number | 6176282370 |
| Mailing Telephone | 6176288000 |
| Mailing Fax Number | 6176282370 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9637 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TUFTS | 009637 | 01 | |
| MA | BS | Y03044 | 01 |
| MA | 0223573 | 05 |
| Street Address |
366 BROADWAY SUITE 100 |
| City | SOMERVILLE |
| State | MA |
| Zip Code | 02145-2812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598976516 | Highland Dental Dmd PC | Dentist | 366 Broadway, 202, Somerville, MA 02145-2812 | 2007-05-24 |
| 1578619672 | Paul Shteynberg | Dentist | 366 Broadway, Suite 202, Somerville, MA 02145 | 2007-01-25 |
| 1164597217 | Richard J Sorbera Dds Shilby D Malouf Dds Inc | Dentist | 366 Broadway, Somerville, MA 01245-2812 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
| 1811478274 | Rolanda Santos Prophete | Counselor | 18 Sargent Ave, Somerville, MA 02145 | 2018-08-23 |
| 1619465101 | Shannon Comer | Registered Nurse | 64 Sycamore St Apartment 1, Somerville, MA 02145 | 2018-04-30 |
| 1184121261 | Deborah Camara | Social Worker | 89 Cross Street, Apt 1, Somerville, MA 02145 | 2018-04-06 |
| 1073047569 | Nicole Patzelt | Dermatology | 192a School St Apt 2, Somerville, MA 02145 | 2017-04-12 |
| 1316327018 | Christina Gasbarro | Family Medicine | Cha Assembly Square Care Center, 5 Middlesex Avenue, Somerville, MA 02145 | 2015-06-08 |
| 1902236359 | Prativa Bhatta | Counselor | 76 Cross St, Somerville, MA 02145 | 2013-11-21 |
| 1427497015 | Veronica Wu | Physician Assistant | 60 Clyde Street, #5, Somerville, MA 02145 | 2013-06-18 |
| 1790045797 | Cambridge Health Alliance | Rehabilitation Unit | 2 Middlesex Avenue, Somerville, MA 02145 | 2012-05-23 |
| 1871809665 | Lauren Holland | Occupational Therapist | 5 Middlesex Avenue, Somerville, MA 02145 | 2010-08-31 |
| Find all providers in zip 02145 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750844080 | C.m.f.-cranio-maxillofacial Surgery Associates | Dentist | 366 Broadway Ste 100, Somerville, MA 02145-2812 | 2019-04-12 |
| 1790765014 | Alan R. Hecht | Dentist | 85 W High St, Somerville, NJ 08876-2114 | 2006-01-20 |
| 1770587230 | Thomas A Chiodo | Dentist | 348 E Main St, Somerville, NJ 08876-3110 | 2005-06-11 |
| 1902201080 | Steven Zambrano, Dds, Pllc | Dentist | 17395 Us Highway 64, Somerville, TN 38068-6162 | 2014-10-30 |
| 1932462181 | Michael E Bell | Dentist | 85 W High St, Somerville, NJ 08876-2114 | 2012-06-22 |
| 1942492376 | Burt S. Abramson Dds Pa | Dentist | 348 E Main St, Somerville, NJ 08876-3110 | 2007-08-09 |
| 1164597217 | Richard J Sorbera Dds Shilby D Malouf Dds Inc | Dentist | 366 Broadway, Somerville, MA 01245-2812 | 2006-11-22 |
| 1073626420 | Burt S Abramson | Dentist | 348 E Main St, Somerville, NJ 08876-3110 | 2006-08-17 |
| 1831128495 | Somerset Oral & Maxillofacial Surgery Group | Dentist | 85 W High St, Somerville, NJ 08876-2114 | 2006-07-03 |
| 1952381279 | Joel R. Efron | Dentist | 85 W High St, Somerville, NJ 08876-2114 | 2006-01-20 |
| Find all providers in SOMERVILLE | ||||
| City | SOMERVILLE |
| Zip Code | 02145 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.