Provider Demographics
NPI:1336869049
Name:MALERBA, GIANCARLO (DDS)
Entity type:Individual
Prefix:DR
First Name:GIANCARLO
Middle Name:
Last Name:MALERBA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11058 CHANDLER BLVD APT 5071
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-5037
Mailing Address - Country:US
Mailing Address - Phone:404-520-6954
Mailing Address - Fax:
Practice Address - Street 1:1447 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2338
Practice Address - Country:US
Practice Address - Phone:323-255-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1228551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice