Marc P Mallory, D.D.S., PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14433 Issued in MI

Practice address

107 E. Washtenaw
Lansing, MI 48933-1822

Phone

(517) 487-5666

Fax

(517) 267-0938

NPI assigned

Jan 12, 2006

Last updated

Oct 26, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Downtown Dental Studio, PLLC

  • Dental Clinic/Center
  • Lansing, MI
  • NPI 1871189423
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1588643134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E. WASHTENAW",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489331822",
            "telephone_number": "517-487-5666",
            "fax_number": "517-267-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E. WASHTENAW",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489331822",
            "telephone_number": "517-487-5666",
            "fax_number": "517-267-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MARC",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PLLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "14433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoinette Mallett, LPC
• Craig Hargurkirat Malli, M.D.
• Nabeel Mallick, MD
• Mallori Mangus-Hayden
• Katelyn E Mallory
• Raj Malosh, PRC
• Whitney Nicole Malzahn, NURSE PRACTITIONER
• Irada Mamukadze, MD
• Neil C Manczak, D.D.S.
• Karlie Ann Mandziara

• General Practice Dentistry in Lansing, MI
• Providers in Lansing, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.