MALLORY EDMONDSON (NPI# 1467920892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467920892 |
| Entity Type | Individual |
| Full Name | MALLORY EDMONDSON |
| Credential | MSDH, RDH |
| Practice Address |
1002 S Esther St South Bend IN 46615-1440 |
| Mailing Address |
4511 N 600 E Rolling Prairie IN 46371-9511 |
| Practice Telephone | 2193638866 |
| Mailing Telephone | 2193638866 |
| Enumeration Date | 2018-11-03 |
| Last Update Date | 2018-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 13007311A | IN | Dental Providers |
| Street Address |
1002 S ESTHER ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46615-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954804 | Healthlinc, Inc. | Clinic/Center | 1002 S Esther St, South Bend, IN 46615 | 2015-06-12 |
| 1841640521 | Andrea Ramthun | Dentist | 1002 S Esther St, South Bend, IN 46615-1440 | 2016-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861897688 | Michelle Jean Streb | Registered Nurse | 1960 Northside Boulevard, South Bend, IN 46615 | 2014-10-23 |
| 1275848962 | Charles Mikel Craig | Optometrist | 220 N. Ironwood Dr., South Bend, IN 46615 | 2010-08-18 |
| 1710219613 | Debra Vasquez | Occupational Therapy Assistant | 1950 Ridgedaleroad, South Bend, IN 46615 | 2010-02-03 |
| 1114259132 | Christopher Joseph Smith | Physical Therapist | 1005 Hickory Rd, South Bend, IN 46615 | 2010-02-01 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1699002642 | Ann G Pryor | Contractor | 1516 E. Wayne St., South Bend, IN 46615 | 2009-11-12 |
| 1891917449 | Logan Community Resources, Inc. | Community/Behavioral Health | 2505 E. Jefferson Blvd, South Bend, IN 46615 | 2007-05-03 |
| 1487712683 | Julie Gaydos Plagens | Dentist | 604 South Eddy St, South Bend, IN 46615 | 2006-12-04 |
| 1629163084 | Edward F Klodzinski | Counselor | 3603 E. Jefferson Blvd., South Bend, IN 46615 | 2006-10-03 |
| 1255448452 | John D Bond Dds Inc | Dentist | 915 S Ironwood, South Bend, IN 46615 | 2006-08-24 |
| Find all providers in zip 46615 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659985497 | Mary Cruz Aguilar | Dental Hygienist | 1901 W Western Ave Ste B, South Bend, IN 46619-3570 | 2020-08-31 |
| 1720605280 | Alma Delia Counsellor | Dental Hygienist | 1901 W Western Ave Ste B, South Bend, IN 46619-3570 | 2020-07-01 |
| 1497317952 | Doreen Cynthia Pienkowski | Dental Hygienist | 326 Chapin St, South Bend, IN 46601-2541 | 2019-07-05 |
| 1871158279 | Kelli Gumm | Dental Hygienist | 326 Chapin St, South Bend, IN 46601-2541 | 2019-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702828 | Oleg Borisyuk | Dental Hygienist | 804 S Green River Rd, Evansville, IN 47715-4106 | 2020-08-28 |
| 1578182309 | Carrie Striplin | Dental Hygienist | 6420 Sunset Ln, Indianapolis, IN 46260-4633 | 2020-04-12 |
| 1154979458 | Courtney Huffman | Dental Hygienist | 2709 Washington Ave Ste 2, Evansville, IN 47714-2412 | 2019-08-29 |
| 1972061562 | Jaime L Kinsey | Dental Hygienist | 4952 W 500 N, Wabash, IN 46992-9017 | 2019-03-04 |
| 1144708512 | Toni Leigh Szabo | Dental Hygienist | 14700 Carrigan Ct, Granger, IN 46530-4224 | 2018-07-29 |
| 1669964581 | Lisa A Greene | Dental Hygienist | Conservative Dental Solutions, 101 N Cross Street, Waveland, IN 47989 | 2018-06-06 |
| 1730670639 | Kathleen Mcmannes | Dental Hygienist | 4629 Melton Rd, Gary, IN 46403-2866 | 2018-05-25 |
| 1699298471 | Stacy Lynn Lashenik | Dental Hygienist | 7101 E Lincoln Hwy, Crown Point, IN 46307-8821 | 2017-07-24 |
| 1861871170 | Mercy Seat Dentistry | Dental Hygienist | 2155 Commerce Drive, Bluffton, IN 46714 | 2015-05-20 |
| 1992118426 | Lynnette Martin-richey | Dental Hygienist | 1453 Flagstone Dr, Dyer, IN 46311-2294 | 2014-06-02 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46615 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.