Mallory C Cicmanec, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

468 Issued in SD

Practice address

4904 S Minnesota Ave
Sioux Falls, SD 57108-2864

Phone

(605) 335-8640

Fax

(605) 332-9956

NPI assigned

May 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Motz DDS PC

  • Dentist
  • Sioux Falls, SD
  • NPI 1922196955
  NPD (past)

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1114338589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082864",
            "telephone_number": "605-335-8640",
            "fax_number": "605-332-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082864",
            "telephone_number": "605-335-8640",
            "fax_number": "605-332-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICMANEC",
        "first_name": "MALLORY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Christopherson
• Thomas J Christopherson, MD
• Stan Christopherson120245
• Lorayne Ann Chua, M.D.
• Cody J Church, PHARMD
• Cigna Tel Drug
• Cigna Tel-Drug
• David J Cinco, CRNA
• Paul Arthur Cink, MD
• Thomas M Cink, MD

• Dentist in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.