Provider Demographics
NPI:1124221312
Name:MALCHEFF, SAM (DDS)
Entity type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:MALCHEFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1657 N CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2948
Mailing Address - Country:US
Mailing Address - Phone:734-335-7270
Mailing Address - Fax:734-763-8100
Practice Address - Street 1:1657 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2948
Practice Address - Country:US
Practice Address - Phone:734-335-7270
Practice Address - Fax:734-763-8100
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010186301223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice