Brian E Mahoney DMD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRIAN E MAHONEY DMD

Doing business as

Main Street Family Dentistry

Practice address

3512 Main St
Vancouver, WA 98663-2224

Phone

(360) 696-2513

NPI assigned

Mar 24, 2021

Last updated

Mar 24, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica Miller

Title

Practice Administrator

Phone

(360) 696-2513

Specialties & licenses 1

Addresses

Other names 1

• Main Street Family Dentistry Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian E Mahoney, DMD

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1356346639
  NPD
• Michelle Clobes

  • Dental Hygienist
  • Vancouver, WA
  • NPI 1669908158
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1083291405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632224",
            "telephone_number": "360-696-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632224",
            "telephone_number": "360-696-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN E MAHONEY DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "360-696-2513"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taryn Alyssa Brewer
• Chelsea Louise Brewster, PHARMD
• Clinton Brewster
• Nakaycia Shelisa Brewton, MSW, LCSW
• Brian C. Alder, DDS, PC
• Brian Scott Killian Ma LMFT LLC
• Allison Brian, PA-C
• Holli Brice, MSW, LCSW, LSWAIC
• Erin Kay Bricker
• Bridge Chiropractic 1 PLLC

• Dental Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.