Provider Demographics
NPI:1578990008
Name:MALEK & KNIGHT DDS PA IV
Entity Type:Organization
Organization Name:MALEK & KNIGHT DDS PA IV
Other - Org Name:AXIOM DENTISTRY OF CARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-481-2220
Mailing Address - Street 1:1398 KILDAIRE FARM RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5567
Mailing Address - Country:US
Mailing Address - Phone:919-481-2220
Mailing Address - Fax:919-481-2227
Practice Address - Street 1:1008 BIG OAK CT
Practice Address - Street 2:SUITE C
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6566
Practice Address - Country:US
Practice Address - Phone:919-266-3380
Practice Address - Fax:919-266-3319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MALEK & KNIGHT DDS PA I
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC7005122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty