Active NPI
Bevin K Malle DDS PA II
Doing business as Carolin Kids Dentistry 2
- General Practice Dentistry
- Waxhaw, NC
National Provider Identifier
1154981371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- BEVIN K MALLE DDS PA II
- Doing business as
- Carolin Kids Dentistry 2
- Practice address
- 9817 Suzanne CT.
Suite B
Waxhaw, NC 28173-8848 - Phone
- (980) 339-8730
- Fax
- (704) 790-0593
- NPI assigned
- Jun 19, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bevin Kiley Malley, DDS
- Title
- Owner/Dentist
- Phone
- (704) 883-4624
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary | ||
| Pediatric Dentistry | 1223P0221X |
Addresses
Primary practice location
9817 Suzanne CT.
Suite B
Waxhaw, NC 28173-8848
Mailing address
3900 Windwood Circle
Charlotte, NC 28226-7928
Phone (704) 790-0590
Other names 1
- Carolin Kids Dentistry 2
National Provider Directory
National Provider DirectoryLocations
9817 Suzanne Ct
Ste B
Waxhaw, NC 28173
Phone (980) 339-8730
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560902400000",
"number": "1154981371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 WINDWOOD CIRCLE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282267928",
"telephone_number": "704-790-0590",
"fax_number": "704-790-0593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9817 SUZANNE CT.",
"address_2": "SUITE B",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281738848",
"telephone_number": "980-339-8730",
"fax_number": "704-790-0593"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEVIN K MALLE DDS PA II",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-19",
"last_updated": "2019-06-19",
"status": "A",
"authorized_official_last_name": "MALLEY",
"authorized_official_first_name": "BEVIN",
"authorized_official_middle_name": "KILEY",
"authorized_official_title_or_position": "OWNER/DENTIST",
"authorized_official_telephone_number": "704-883-4624",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Carolin Kids Dentistry 2",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.