Mallory Lanford, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D.007309-C1 Issued in AL

Practice address

6807 Tattersall Way
Birmingham, AL 35242-4237

Phone

(205) 508-9523

NPI assigned

May 8, 2023

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

Other names 1

• Mallory Mathias Former name

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1346939089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6807 TATTERSALL WAY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424237",
            "telephone_number": "205-508-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 TATTERSALL WAY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424237",
            "telephone_number": "205-508-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANFORD",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D.007309-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MATHIAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Lane
• Sandra Elizabeth Lane, CRNA
• Terri Renea Lane, CRNP
• Deborah Jones Laney, CRNP
• Mary Catherine Laney, M.D.
• Jennifer Brooke Lang, CRNA
• Madeline Anne Lang, NBC-HWC
• Kelly Langan, M.D.
• Lange Family Dentistry, LLC (Edwards Lake Dental)
• Andrew Jason Lange, DMD

• General Practice Dentistry in Birmingham, AL
• Providers in Birmingham, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.