Mallory Elizabeth Goding

Primary specialty

DentistTaxonomy code 122300000X

License

DEN03602 Issued in RI

Practice address

1359 Main Rd
Tiverton, RI 02878-4426

Phone

(401) 624-9177

Fax

(401) 624-9233

NPI assigned

May 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

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.

• Dutchman Dental LLC

  • General Practice Dentistry
  • Tiverton, RI
  • NPI 1922109370
  NPD (past)
• Dutchmen Dental LLC

  • General Practice Dentistry
  • Tiverton, RI
  • NPI 1912172016
  NPD (past)

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1609304542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 GARFIELD ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028401344",
            "telephone_number": "717-858-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 MAIN RD",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784426",
            "telephone_number": "401-624-9177",
            "fax_number": "401-624-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODING",
        "first_name": "MALLORY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN03602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Gay, PSY.D.
• Nicole Gifford, NP
• Beatriz Giraldo
• Jennifer Glynn
• Clyde William Godfrey I, L.I.C.S.W.
• Carla Gomes, NP
• Suzanne Gonsalves, PT
• Laura E Grafov, DPT
• Rachel Grant
• Stephen D Groskin, MD

• Dentist in Tiverton, RI
• Providers in Tiverton, RI by specialty
• Dentist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.