Raymond Frank Mallinak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005236 Issued in VA

Practice address

604 E Church St
Martinsville, VA 24112-3008

Phone

(276) 632-2189

Fax

(276) 638-2306

NPI assigned

Dec 4, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Raymond F. Mallinak, DDS

  • General Practice Dentistry
  • Martinsville, VA
  • NPI 1447585997
  NPD (past) Authorized official
• Wade Family Holdings LLC

  dba mallinak family dentistry

  • Dental Clinic/Center
  • Martinsville, VA
  • NPI 1326881723
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245398114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3966",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241153966",
            "telephone_number": "276-632-2189",
            "fax_number": "276-638-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E CHURCH ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241123008",
            "telephone_number": "276-632-2189",
            "fax_number": "276-638-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLINAK",
        "first_name": "RAYMOND",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9178603",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Charles Madonia
• Mark T Mahoney, D.O.
• Bobbie Sue Maiorano, M.S. CCC-SLP
• Emily Mallinak, DDS
• Laura R Mallinak
• Benjamin Lowell Mann, PA
• Peter J Mannen, PA-C
• Mark a. Crabtree DDS, LTD.
• Mark T Mahoney DO PC
• Mark Thomas Mahoney, D.O., P.C. (Mahoney Family Medicine)

• General Practice Dentistry in Martinsville, VA
• Providers in Martinsville, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.