DR. MOZAMEL AHMED MALIK (NPI# 1619503299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619503299 |
| Entity Type | Individual |
| Full Name | DR. MOZAMEL AHMED MALIK |
| Credential | DMD |
| Practice Address |
4112 Atlanta Hwy Ste 100 Loganville GA 30052-4930 |
| Mailing Address |
220 Ponce De Leon Pl Unit 343 Decatur GA 30030-3256 |
| Practice Telephone | 4703853595 |
| Mailing Telephone | 4047814467 |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-07-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN016007 | GA | Dental Providers |
| Street Address |
4112 ATLANTA HWY STE 100 |
| City | LOGANVILLE |
| State | GA |
| Zip Code | 30052-4930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
| 1184285025 | Felicia Maria Anderson | Counselor | 272 Fox Run, Loganville, GA 30052 | 2019-06-21 |
| 1225502768 | Jackie Kabahuma Zziwa | Registered Nurse | 4072 Atlanta High Way, Loganville, GA 30052 | 2019-01-17 |
| 1598243024 | Afolasade A Adeyemo | In Home Supportive Care | 154 Towler Shoals Dr, Loganville, GA 30052 | 2018-08-06 |
| 1831688654 | Julia Smith | Physician Assistant | 2745 Loganville Hwy, Loganville, GA 30052 | 2018-05-07 |
| 1306335534 | Emily Jannine Jamshedi | Physician Assistant | 3461 Skyland Ridge Ct, Loganville, GA 30052 | 2018-05-03 |
| 1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
| 1942738901 | Local Dental Partners, LLC | Clinic/Center | 4353 Atlanta Highway Suite. 300, Loganville, GA 30052 | 2017-06-02 |
| 1649702804 | Cynthia Reeves | Counselor | 4160 Logan Drive, Loganville, GA 30052 | 2017-03-28 |
| 1689049330 | Samuel S Kwon - Loganville Dmd PC | Dentist | 2101 Baker Carter Drive, Suite 200, Loganville, GA 30052 | 2015-12-07 |
| Find all providers in zip 30052 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497275226 | Katelyn R Smith | Dentist | 3973 Atlanta Hwy Ste 100, Loganville, GA 30052-3750 | 2017-06-22 |
| 1104355395 | Dorian Grace Longshore | Dentist | 4799 Atlanta Hwy # 500, Loganville, GA 30052-7307 | 2017-06-09 |
| 1336693506 | Loganville Dentist Office, PC | Dentist | 4799 Atlanta Hwy, Suite 520, Loganville, GA 30052-7307 | 2016-08-05 |
| 1578976098 | Beau Upshaw | Dentist | 3238 Krisam Creek Dr, Loganville, GA 30052-7942 | 2014-06-03 |
| 1154682219 | Loganville Dental Associates | Dentist | 150 Highway 78, Loganville, GA 30052-2277 | 2012-06-06 |
| 1275810129 | Princeton Dental Group-loganville | Dentist | 4353 Atlanta Hwy, Loganville, GA 30052-3214 | 2011-11-07 |
| 1477695807 | Kevin F Blair | Dentist | 3805 Harrison Rd, Loganville, GA 30052-2462 | 2007-02-13 |
| 1942397872 | Brian Lee Smith | Dentist | 3973 Atlanta Hwy # 78, Suite 100, Loganville, GA 30052-3752 | 2006-10-10 |
| 1558474304 | Victor A. Koehler | Dentist | 3238 Krisam Creek Dr., Loganville, GA 30052 | 2006-08-16 |
| 1679577936 | Ponnie Davis Poisal | Dentist | 3973 Atlanta Hwy, Ste 100, Loganville, GA 30052-3750 | 2005-06-02 |
| Find all providers in LOGANVILLE | ||||
| City | LOGANVILLE |
| Zip Code | 30052 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.