Provider Demographics
NPI:1477339067
Name:MALEKI, HANNAH (DDS)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MALEKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6748 EL SOL AVE
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-2882
Mailing Address - Country:US
Mailing Address - Phone:816-666-2100
Mailing Address - Fax:
Practice Address - Street 1:57019 YUCCA TRL STE C
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7909
Practice Address - Country:US
Practice Address - Phone:760-820-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1092981223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health