DR. SHIBLY D MALOUF DDS NPI 1053489682

NPI Information

NPI: 1053489682
Provider Name: DR. SHIBLY D MALOUF, DDS
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
366 BROADWAY
SUITE 100
SOMERVILLE, MA
ZIP 02145
Phone: (617) 628-8000
Get Directions

DR. Shibly D Malouf, DDS is an oral and maxillofacial surgery dentist in Somerville, MA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Shibly D Malouf, DDS NPI is 1053489682. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

366 BROADWAY
SUITE 100
SOMERVILLE, MA
ZIP 02145-812
Phone: (617) 628-8000
Fax: (617) 628-2370

The enumeration date for this NPI number is 12/1/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	9637	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Y03044	OTHER	MASSACHUSETTS	BS
2	0223573	MEDICAID	MASSACHUSETTS
3	009637	OTHER		TUFTS
4	T56499	MEDICARE UPIN
5	X03044	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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