Mallory Jo Nyenhuis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D011313 Issued in AZ

Practice address

223 N San Francisco St Ste 104
Flagstaff, AZ 86001-4657

Phone

(928) 275-1252

NPI assigned

Apr 18, 2016

Last updated

Feb 13, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Practice roles

Locations

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.

• Sleep Remedies, LLC

  dba Sleep REMedies

  • Customized Equipment (DME)
  • Flagstaff, AZ
  • NPI 1205609245

  Dentist

  NPD Authorized official
• North Country Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kingman, AZ
  • NPI 1023432424
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1619345675
  NPD
• North Country Healthcare, Inc.

  dba Flagstaff Pediatric Care

  • Pediatrics Physician
  • Flagstaff, AZ
  • NPI 1669911764
  NPD (past)
• Taylor Hunt DMD PLLC

  dba Hunt Dentistry

  • Dental Clinic/Center
  • Snowflake, AZ
  • NPI 1689290686
  NPD (past)
• Southern Smiles Dental Studio Columbia LLC

  • Dental Clinic/Center
  • Columbia, SC
  • NPI 1477055481
  NPD (past)

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1437503364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2756 W HIGHLAND MEADOWS DR",
            "city": "WILLIAMS",
            "state": "AZ",
            "postal_code": "860469179",
            "telephone_number": "920-918-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N SAN FRANCISCO ST STE 104",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014657",
            "telephone_number": "928-275-1252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Williams",
            "state": "AZ",
            "postal_code": "860460110",
            "country_code": "US",
            "telephone_number": "928-635-4441",
            "fax_number": "928-635-4403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYENHUIS",
        "first_name": "MALLORY",
        "middle_name": "JO",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nourished Nutrition Consulting, LLC
• Nancy Ann Novak, RN
• Katherine Maples Novotny, RN
• NP Fromhome, LLC
• Hannah Ruth Nunez, LPC
• Sherry O'Brien, NURSE PRACTITIONER
• Claire O'Connell
• Rachel Michelle O'Connor, D.P.M.
• Kelly Marie O'Donnell, LCSW
• Meghan O'Donnell, MD

• Dentist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.