Mallory Girdler, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.027003 Issued in OH

Practice address

1009 E Broad St
Elyria, OH 44035-6303

Phone

(440) 366-8844

NPI assigned

Oct 20, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1992422075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 E BROAD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356303",
            "telephone_number": "440-366-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 E BROAD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356303",
            "telephone_number": "440-366-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRDLER",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drpegg@windstream.net",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1009 E Broad St",
            "city": "Elyria",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440356303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasmine Gilbert
• Kristen Lynn Gilbert, RN, CDCA
• Mary Lauretta Gilchrist
• Brandon Marcus Gill
• Julie Gillette, C.R.N.A.
• Danette Joan Gissinger, CRNA
• Kathleen Gittinger, OTR/L
• Sydney Taylor Gober
• Tammt Goelle
• Renee T Golowenski, LPCC

• General Practice Dentistry in Elyria, OH
• Providers in Elyria, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.