NPIMap

Organization Active NPI

Mallory Community Health

Doing business as Mallory Community Health Center Dental

  • Dental Clinic/Center
  • Lexington, MS
National Provider Identifier
1982291415
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MALLORY COMMUNITY HEALTH
Doing business as
Mallory Community Health Center Dental
Practice address
300 Yazoo St
Lexington, MS 39095-3623
Phone
(662) 834-5000
Fax
(662) 834-5003
NPI assigned
Dec 30, 2020
Last updated
Dec 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
Mrs. Latonya Mabry
Title
Business Manager
Phone
(662) 834-0746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

300 Yazoo St
Lexington, MS 39095-3623

Mailing address

PO Box 479
Lexington, MS 39095-0479
Phone (662) 834-1857

Other names 1

  • Mallory Community Health Center Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mallory Community Health6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Yazoo St
Lexington, MS 39095
Phone (662) 834-5000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1982291415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390950479",
            "telephone_number": "662-834-1857",
            "fax_number": "662-834-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 YAZOO ST",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390953623",
            "telephone_number": "662-834-5000",
            "fax_number": "662-834-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLORY COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "MABRY",
        "authorized_official_first_name": "LATONYA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "662-834-0746",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mallory Community Health Center Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.