MALTA FAMILY DENTAL LLC (NPI# 1063791218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063791218 |
| Entity Type | Organization |
| Organization Name | MALTA FAMILY DENTAL LLC |
| Practice Address |
304 Van Buren St Malta IL 60150-9512 |
| Practice Telephone | 8158255025 |
| Practice Fax Number | 8155160205 |
| Mailing Telephone | 8158255025 |
| Mailing Fax Number | 8155160205 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |
| Authorized Official Name | MRS. ANNE ELIZABETH ANDERSON (OFFICE MANAGER) |
| Authorized Official Telephone | 8158255025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | 020010952 | IL | Dental Providers |
| Y | 122300000X | Dentist | 019027588 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 019027588 | 05 | |
| IL | 020010952 | 05 |
| Street Address |
304 VAN BUREN ST |
| City | MALTA |
| State | IL |
| Zip Code | 60150-9512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376517722 | Michele L Roberts | Physician Assistant | 21193 Malta Rd, Malta, IL 60150-9600 | 2006-02-14 |
| 1760729925 | Center for Family Health - Malta | Clinic/Center | 21193 Malta Rd, Malta, IL 60150-9600 | 2013-01-08 |
| 1457654295 | Ben Gordon Center | Clinic/Center | 21193 Malta Rd, Bldg. A - U154, Malta, IL 60150-9600 | 2010-12-17 |
| 1225218365 | Northern Illinois University | Clinic/Center | 21193 Malta Rd, Malta, IL 60150-9600 | 2007-11-06 |
| 1275068660 | Marissa Nicole Maeder | Specialist/Technologist, Other | 205 S 6th St, Malta, IL 60150-9703 | 2017-04-24 |
| 1922351386 | Malta Fire Protection District | Ambulance | 308 Jefferson St, Malta, IL 60150-9738 | 2012-10-23 |
| 1558509208 | Jill Reiland | Occupational Therapist | 510 N 3rd St, Malta, IL 60150-9771 | 2009-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507328 | Cassandra Coppola | Physical Therapy Assistant | 2202 Concord St, Malta, NY 12020-5265 | 2020-10-27 |
| 1215553839 | Eloise Porte Parker | Psychologist | 92 Lakeshore Dr, Malta, NY 12020-6240 | 2020-06-19 |
| 1225650849 | Mark Nistico | Registered Nurse | 23 Mayapple Way, Malta, NY 12020-4390 | 2020-05-18 |
| 1831710979 | Elizabeth Jean Simpson | Physical Therapy Assistant | 801s 3rd St., Malta, MT 59538 | 2020-04-29 |
| 1811529415 | Peter Joseph Valastro Jr. | Registered Nurse | 2452 Us Rt 9 Suite 206, Malta, NY 12020 | 2020-02-11 |
| 1114561859 | Rad Bintareef | Ophthalmology | 658 Malta Ave Ste 101, Malta, NY 12020-4105 | 2019-11-06 |
| 1073077020 | Kaleb Wilkins | Registered Nurse | 859 South Main St., Malta, OH 43758 | 2019-01-24 |
| 1336613199 | Tyson Copenhaver Carney | Specialist/Technologist | 631 S 6th Ave E, Malta, MT 59538-8893 | 2019-01-15 |
| 1700356300 | Melissa Lynn Jones | Registered Nurse | 545 N Riverview Rd, Malta, OH 43758-9301 | 2018-11-27 |
| 1922583186 | Tiffany Marie Mcgrew | Licensed Practical Nurse | 3664 Finley Lane, Malta, OH 43758 | 2018-10-03 |
| Find all providers in MALTA | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699267500 | Christopher Burns | Dentist | 2443 State Route 9, Malta, NY 12020-4518 | 2018-06-06 |
| 1497910962 | Christina Cocozzo | Dentist | 4 Hemphill Pl, Suite 151, Malta, NY 12020-4426 | 2008-07-24 |
| 1679745129 | Harry M Clark IIi | Dentist | 519 State Route 67, Malta, NY 12020-4334 | 2008-03-25 |
| 1649554544 | Vera Popova Salvatore | Dentist | 127 Dunning St, Malta, NY 12020-4406 | 2011-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629076 | Align Dental Group PC. | Dentist | 2605 Grand Ave Ste A, Waukegan, IL 60085-2410 | 2020-11-06 |
| 1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
| 1982201505 | Ashley Rodriguez | Dentist | 2208 N Mannheim Rd, Melrose Park, IL 60164-1837 | 2020-10-06 |
| 1831796853 | Shaista Hasan | Dentist | 1840 Harvest Ln, Glendale Heights, IL 60139-1939 | 2020-10-02 |
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1477160190 | Smilesbysangha LLC | Dentist | 118 Barrington Commons Ct Ste 201, Barrington, IL 60010-3259 | 2020-09-27 |
| 1477160331 | Samer Mosoof | Dentist | 9 Monroe Ct, Streamwood, IL 60107-1365 | 2020-09-24 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1275145534 | Moondrift Sleep Solutions, LLC | Dentist | 837 N Wilke Rd, Arlington Heights, IL 60005-1047 | 2020-08-18 |
| 1023629664 | Mockunas Dental PC | Dentist | 13530 S Route 59 Unit 120, Plainfield, IL 60544-5659 | 2020-08-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MALTA FAMILY DENTAL LLC.
| 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.