Individual provider Active NPI

Mallory M Adler, DDS

  • General Practice Dentistry
  • Blue Ash, OH
National Provider Identifier
1902169170
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30023748 Issued in OH
Practice address
9346 Towne Square Ave
Blue Ash, OH 45242-6943
Phone
(513) 793-3535
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30023748 OH Primary

Addresses

Primary practice location

9346 Towne Square Ave
Blue Ash, OH 45242-6943

Mailing address

7997 Kenilworth LN
Montgomery, OH 45242-5123
Phone (513) 205-5773

Other names 1

  • Mallory J. Mandel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30023748OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James D. Petricone DDS & Stephen H. Pick DDS Inc General Practice Past Accepting new patients
Blue Ash Smiles Group Inc General Practice PastSince Jul 24, 2022 Accepting new patients
Mallory Adler DDS LLC General Practice Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1902169170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7997 KENILWORTH LN",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452425123",
            "telephone_number": "513-205-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9346 TOWNE SQUARE AVE",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426943",
            "telephone_number": "513-793-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLER",
        "first_name": "MALLORY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30023748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MANDEL",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blue Ash, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.