Provider Demographics
NPI:1679798953
Name:MALEKZADEH, ROYA (DDS)
Entity Type:Individual
Prefix:
First Name:ROYA
Middle Name:
Last Name:MALEKZADEH
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 1:5943 EL ESCORPION RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3924
Mailing Address - Country:US
Mailing Address - Phone:818-943-8580
Mailing Address - Fax:
Practice Address - Street 1:5943 EL ESCORPION RD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3924
Practice Address - Country:US
Practice Address - Phone:818-943-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA-506421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD50642OtherDENTI-CAL