Provider Demographics
NPI:1245631472
Name:LAILA L. MALEK DDS INC
Entity type:Organization
Organization Name:LAILA L. MALEK DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAILA
Authorized Official - Middle Name:LABIB
Authorized Official - Last Name:MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-550-0500
Mailing Address - Street 1:801 N TUSTIN AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3609
Mailing Address - Country:US
Mailing Address - Phone:714-550-0500
Mailing Address - Fax:714-550-9560
Practice Address - Street 1:801 N TUSTIN AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3609
Practice Address - Country:US
Practice Address - Phone:714-550-0500
Practice Address - Fax:714-550-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43195122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty