Mallard Dental Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MALLARD DENTAL INC

Practice address

33 S Addison Rd
Ste 101
Addison, IL 60101-3868

Phone

(630) 834-4343

Fax

(630) 834-6308

NPI assigned

Dec 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Konstadina Anastasia Aralles, DDSNPI 1578733812

Title

President

Phone

(630) 834-4343

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Konstadina Anastasia Aralles, D.D.S.

  • Dentist
  • Addison, IL
  • NPI 1578733812
  NPD (past) Authorized official

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467437756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S ADDISON RD",
            "address_2": "STE 101",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013868",
            "telephone_number": "630-834-4343",
            "fax_number": "630-834-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 S ADDISON RD",
            "address_2": "STE 101",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013868",
            "telephone_number": "630-834-4343",
            "fax_number": "630-834-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARD DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARALLES",
        "authorized_official_first_name": "KONSTADINA",
        "authorized_official_middle_name": "ANASTASIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-834-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103045",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001079",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Main Medical Center LTD
• Iqbal Majeed
• Syed A Majeed, DMD
• Syed Arshad Makki
• Faisal Malik
• Dana Maniscalco
• Magdalena Marcinek, DPM
• Lisa A Markowski
• James Martin
• Cara A. Martinez, APN-CNP

• Pediatric Dentistry in Addison, IL
• Providers in Addison, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.