William Andrew Mallard, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10487 Issued in TN

Practice address

11201 W Point Dr Ste 100
Knoxville, TN 37934-2833

Phone

(865) 309-4020

NPI assigned

Jul 17, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• William a. Mallard, D.D.S., PLLC

  • Dental Clinic/Center
  • Knoxville, TN
  • NPI 1427899285
  NPD Authorized official
• Knoxville Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Sevierville, TN
  • NPI 1447627914
  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1780091132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6821 HAVERHILL DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092612",
            "telephone_number": "731-445-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 W POINT DR STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342833",
            "telephone_number": "865-309-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARD",
        "first_name": "WILLIAM",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4003",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "10487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q028954",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shahid Ahmed Malik, MD
• Amanda R Malinowski
• Dhatri Malipeddi, MD
• Ittoop Thomas Maliyekkel, MD
• Alaina Cope Mallard, PT
• Srinithya Mallela, M.D.
• Kelly M Mallory, PT
• Max Christian Mallory
• Malone & Costa, PLLC
• Cassandra Malone, FNP-BC

• Pediatric Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.