Provider Demographics
NPI:1932375128
Name:MALHOTRA, MENKA (DMD)
Entity type:Individual
Prefix:
First Name:MENKA
Middle Name:
Last Name:MALHOTRA
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 1:1350 SPRING STREET
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-389-1950
Mailing Address - Fax:770-874-0826
Practice Address - Street 1:2230 TOWNE LAKE PARKWAY
Practice Address - Street 2:BUILDING 1300, STE 100
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5524
Practice Address - Country:US
Practice Address - Phone:678-445-5444
Practice Address - Fax:770-874-0826
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP500371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry