Mallory Dawson, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS0000010389 Issued in TN

Practice address

510 S Jefferson Ave
Cookeville, TN 38501-4010

Phone

(931) 854-1200

NPI assigned

Mar 13, 2017

Last updated

Jan 20, 2021By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dream Pediatric Dentistry and Orthodontics, LLC

  • Pediatric Dentistry
  • Newnan, GA
  • NPI 1003492224

  Orthodontics and Dentofacial Orthopedics

  NPD Authorized official
• Spark Dental TN, PLLC

  dba Cumberland Pediatric Dentistry

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Smyrna, TN
  • NPI 1154087120
  NPD (past)

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1629519525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S JEFFERSON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014010",
            "telephone_number": "931-854-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S JEFFERSON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014010",
            "telephone_number": "931-854-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS0000010389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Davis, PMHNP
• McKenzie Brooke Davis, PA-C
• Miranda Kathleen Davis, RBT
• Passionate Shinese Davis, PMHNP-BC
• Zachary Boyd Davis
• Sara Iris Debovis, NP
• Chelsea Delk, APRN
• Christopher Delk
• James E Delk, CRNA
• Sarah Delk, APN

• Orthodontics and Dentofacial Orthopedics Dentistry in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.