Provider Demographics
NPI:1386741858
Name:MALEKI, FARZAM (BDS, MS)
Entity type:Individual
Prefix:DR
First Name:FARZAM
Middle Name:
Last Name:MALEKI
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 E PINNACLE PEAK RD
Mailing Address - Street 2:250
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3435
Mailing Address - Country:US
Mailing Address - Phone:480-538-5270
Mailing Address - Fax:
Practice Address - Street 1:7450 E PINNACLE PEAK RD
Practice Address - Street 2:250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3435
Practice Address - Country:US
Practice Address - Phone:480-538-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5550122300000X
IL019025258122300000X
MND11625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist