Stephen C Mallow Dba Upper Tract Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STEPHEN C MALLOW DBA UPPER TRACT DENTAL

Doing business as

Upper Tract Dental

Practice address

9030 Petersburg Pike
Upper Tract, WV 26866-8014

Phone

(304) 358-7200

Fax

(304) 358-7284

NPI assigned

Jul 31, 2023

Last updated

Aug 3, 2023By 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

Lisa D Mallow

Title

Office Manager

Phone

(304) 358-8152

Specialties & licenses 1

Addresses

Other names 1

• Upper Tract Dental Doing business as

Locations

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.

• Siera Mallow, DDS

  • General Practice Dentistry
  • Upper Tract, WV
  • NPI 1588222319
  NPD
• Stephen C Mallow, DDS

  • Dentist
  • Upper Tract, WV
  • NPI 1720185523
  NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1083395081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8791 PETERSBURG PIKE",
            "city": "UPPER TRACT",
            "state": "WV",
            "postal_code": "268668016",
            "telephone_number": "304-358-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 PETERSBURG PIKE",
            "city": "UPPER TRACT",
            "state": "WV",
            "postal_code": "268668014",
            "telephone_number": "304-358-7200",
            "fax_number": "304-358-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN C MALLOW DBA UPPER TRACT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "MALLOW",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-358-8152"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upper Tract Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Upper Tract Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teresa Mowery
• Shelia Propst
• Armeda Faye Ryder
• Delores Shirk
• Rebecca Sly
• Deborah F Turner
• Uha Upper Trace (Paasgrp)
• Uha Upper Tract Lab
• Kelsey Vance

• General Practice Dentistry in Upper Tract, WV
• Providers in Upper Tract, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.