Mallory Jane Hackbarth, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

10831 Issued in SC

Practice address

105 Ben Casey Dr Ste 121
Fort Mill, SC 29708-8574

Phone

(803) 802-3681

NPI assigned

May 27, 2016

Last updated

Dec 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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.

• Gallatin Smiles Dentistry,PC

  dba Gallatin Smiles Dentistry

  • Dentist
  • Gallatin, TN
  • NPI 1487108684
  NPD (past)

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1265880470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR STE 121",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088574",
            "telephone_number": "803-802-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR STE 121",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088574",
            "telephone_number": "803-802-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKBARTH",
        "first_name": "MALLORY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "10831",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Guerrieri
• Olivia Guillen Blas, RBT
• Lisa Gunter, LCSW, LISW CP
• Janel A Guntle, MA, LPC
• H2Home Therapy, Inc
• Amiya Haggins, RBT
• Hall Chiropractic Center, LLC
• Alasia Hall, RBT
• Jerome Hall, LCSW, LCAS-A
• Melanie Hall

• Endodontics in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Endodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.