Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1588218077 Individual Practitioner Female Practitioner

Dr. Malissa Frederique , DDS

Dentist - General Practice • Brooklyn, NY

Professional Overview & Biography Verified Profile Summary

Dr. Malissa Frederique, DDS is a registered healthcare professional specializing in Dentist - General Practice in Brooklyn, NY. Practice services are available at BROOKLYN PLAZA MEDICAL CENTER, INC. under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

Brooklyn Plaza Medical Center, Inc.
650 Fulton Street

Brooklyn, NY 11217

Telephone 7185969800
Fax 7188555628
Associated Practice Facility / Clinic
🏢 Brooklyn Plaza Medical Center Facility NPI 1992711444

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Brooklyn, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.8 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
926 Specialists

Practicing in Brooklyn, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-20
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 061360

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License NY 061360-01

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
07959479 (NY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

37 Associated Practitioners
Daijasia Mcintosh

Social Worker

NPI 1053071621
Nora Chanko

Social Worker

NPI 1053993816
Dr. Chris Cho , DDS

Dentist - General Practice

NPI 1124497318

Doctor of Dental Surgery

Albina Chua

Pediatrics

NPI 1134198591
Samantha Smith

Counselor - Addiction (Substance Use Disorder)

NPI 1154985745
Nan-Tsun Lai

Pediatrics

NPI 1205241155

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location March 12, 2025

Registered at BROOKLYN PLAZA MEDICAL CENTER, INC., 650 FULTON STREET, BROOKLYN, NY 11217 (Tel: 7185969800)

📍
Updated Business Mailing Address March 12, 2025

Registered at 650 FULTON STREET, BROOKLYN, NY 11217 (Tel: 7185969800)

📍
Updated Practice Location February 20, 2025

Registered at 650 FULTON ST, BROOKLYN, NY 112171517 (Tel: 7185969800)

📍
Updated Business Mailing Address February 20, 2025

Registered at 650 FULTON ST, BROOKLYN, NY 112171517

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 20, 2025

Dentist (License #061360-01 in NY)

NPI Profile Active August 01, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location August 01, 2019

Registered at 8268 164TH ST, JAMAICA, NY 114321104 (Tel: 3477335984)

📍
Updated Business Mailing Address August 01, 2019

Registered at 8268 164TH ST, JAMAICA, NY 114321104 (Tel: 3477335984)

👤
Provider Name / Credentials Updated August 01, 2019

Recorded as MALISSA FREDERIQUE, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration August 01, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588218077
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 01, 2019
Last Update: March 12, 2025
Sole Proprietor: No

Mailing Address

650 Fulton Street

Brooklyn, NY 11217

Phone: 7185969800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.