Provider Demographics
NPI:1265949903
Name:MALIXI, JODECI (DMD)
Entity type:Individual
Prefix:DR
First Name:JODECI
Middle Name:
Last Name:MALIXI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 VIA PANZANI
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8246
Mailing Address - Country:US
Mailing Address - Phone:802-829-1311
Mailing Address - Fax:
Practice Address - Street 1:1937 N MILITARY TRL STE U
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-4764
Practice Address - Country:US
Practice Address - Phone:561-683-7699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT01601338371223G0001X
OH30.0260641223G0001X
FLDN26760122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice