Provider Demographics
NPI:1073169603
Name:ABDELMALIK, WILYAM (DMD)
Entity type:Individual
Prefix:DR
First Name:WILYAM
Middle Name:
Last Name:ABDELMALIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N RETAIL CT
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-9626
Mailing Address - Country:US
Mailing Address - Phone:843-874-4060
Mailing Address - Fax:
Practice Address - Street 1:7510 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2742
Practice Address - Country:US
Practice Address - Phone:702-490-9925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9446122300000X
NV7623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC9446OtherBOARD OF DENTISTRY
NV7623OtherNEVADA BOARD OF DENTISTRTY