Active NPI
Lauri Neil Malolo, B.A., R.D.H.
- Dental Hygienist
- Gilbert, AZ
National Provider Identifier
1578652475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2596
- Practice address
- 2483 S Market St
Suite 101
Gilbert, AZ 85295-0722 - Phone
- (480) 857-1044
- NPI assigned
- Oct 11, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2596 | AZ | Primary |
| Dental Hygienist | 124Q00000X | DH-8961 | OH |
Addresses
Primary practice location
2483 S Market St
Suite 101
Gilbert, AZ 85295-0722
Mailing address
1753 E Cotton CT
Gilbert, AZ 85234-6134
Phone (480) 635-0345
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2596 | AZ | MD | Dental Hygienist |
| DH-8961 | OH | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Tan Dental Group, LLP | 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.
-
dba San Tan Dental Group
- General Practice Dentistry
- Gilbert, AZ
- NPI 1225234149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1578652475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1753 E COTTON CT",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852346134",
"telephone_number": "480-635-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2483 S MARKET ST",
"address_2": "SUITE 101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852950722",
"telephone_number": "480-857-1044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALOLO",
"first_name": "LAURI",
"middle_name": "NEIL",
"credential": "B.A., R.D.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "2596",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OH",
"license": "DH-8961",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.