Provider Demographics
NPI:1134311079
Name:MALLORY, JAMES B (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:MALLORY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16201 N SCOTTSDALE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1415
Mailing Address - Country:US
Mailing Address - Phone:480-935-6989
Mailing Address - Fax:623-526-9055
Practice Address - Street 1:16201 N SCOTTSDALE RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1415
Practice Address - Country:US
Practice Address - Phone:480-935-6989
Practice Address - Fax:623-526-9055
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ73131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice