Steven Charles Maller, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

27851 Issued in TX

Practice address

4501 McCullough Ave
Suite 104
San Antonio, TX 78212-1660

Phone

(210) 824-0111

Fax

(210) 828-9103

NPI assigned

Jul 17, 2006

Last updated

Aug 7, 2014By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1760400022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 MCCULLOUGH AVE",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121660",
            "telephone_number": "210-824-0111",
            "fax_number": "210-828-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MCCULLOUGH AVE",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121660",
            "telephone_number": "210-824-0111",
            "fax_number": "210-828-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLER",
        "first_name": "STEVEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NE",
            "license": "5891",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "27851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Malit
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• Kye Edward Mallernee, D.M.D.
• Kimberly A. Mallery, M.D.
• Mary C Mallett
• Chaithanya Mallikarjun, MD

• Periodontics in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.