Provider Demographics
NPI:1447744131
Name:ALMALKI, FOUAD (DDS)
Entity Type:Individual
Prefix:
First Name:FOUAD
Middle Name:
Last Name:ALMALKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E MONTGOMERY AVE APT 316B
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2420
Mailing Address - Country:US
Mailing Address - Phone:267-392-9784
Mailing Address - Fax:
Practice Address - Street 1:1533 VOLVO PKWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-8489
Practice Address - Country:US
Practice Address - Phone:757-320-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014160621223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics