Active NPI
Mallori Ashford, DDS
- General Practice Dentistry
- Fayetteville, GA
National Provider Identifier
1962239442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN123606
- Practice address
- 101 Beckett LN Ste 404
Fayetteville, GA 30214-7159 - Phone
- (770) 461-0400
- NPI assigned
- Sep 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN123606 | GA | Primary |
Addresses
Primary practice location
101 Beckett LN Ste 404
Fayetteville, GA 30214-7159
Mailing address
101 Beckett LN Ste 404
Fayetteville, GA 30214-7159
Phone (404) 451-0559
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN123606 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1962239442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BECKETT LN STE 404",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147159",
"telephone_number": "404-451-0559",
"fax_number": "770-461-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BECKETT LN STE 404",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147159",
"telephone_number": "770-461-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHFORD",
"first_name": "MALLORI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-18",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN123606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.