Active NPI
Mallory Weeks, DDS
- Dentist
- Dyersburg, TN
National Provider Identifier
1285287045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11119
- Practice address
- 95 US Highway 51 Byp W
Dyersburg, TN 38024-1935 - Phone
- (731) 286-1271
- NPI assigned
- Jul 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11119 | TN | Primary |
Addresses
Primary practice location
95 US Highway 51 Byp W
Dyersburg, TN 38024-1935
Mailing address
95 US Highway 51 Byp W
Dyersburg, TN 38024-1935
Phone (731) 286-1271
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11119 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wild Smiles Pediatric Dentistry LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Jackson, TN
- NPI 1639472673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1285287045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 US HIGHWAY 51 BYP W",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241935",
"telephone_number": "731-286-1271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 US HIGHWAY 51 BYP W",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241935",
"telephone_number": "731-286-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEEKS",
"first_name": "MALLORY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-22",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "11119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyersburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.