DR. MALLORY K RUSSELL (NPI# 1275022782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275022782 |
| Entity Type | Individual |
| Full Name | DR. MALLORY K RUSSELL |
| Other Name | MALLORY K COCHRAN |
| Credential | D.D.S |
| Practice Address |
6400 Canoga Avenue Warner Center Dental Group #180 Woodland Hills CA 91367 |
| Practice Telephone | 8188872880 |
| Mailing Telephone | 8188872880 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2019-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
104077 | CA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
6400 CANOGA AVENUE WARNER CENTER DENTAL GROUP #180 |
| City | WOODLAND HILLS |
| State | CA |
| Zip Code | 91367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144837386 | Welby Way Home LLC | Hospice Care, Community Based | 21550 Oxnard St., 3rd Floor Suite # 57, Woodland Hills, CA 91367 | 2020-09-30 |
| 1821619180 | Jmg Recovery, Inc | Substance Abuse Rehabilitation Facility | 23043 Hatteras Street, Woodland Hills, CA 91367 | 2020-04-28 |
| 1952952137 | Carol L. Frankel | Technician | 22616 Victory Blvd., Woodland Hills, CA 91367 | 2019-09-27 |
| 1346890191 | Sharie Renell Boudreaux | Behavioral Analyst | 210600 Oxnard St, Suite 1800, Woodland Hills, CA 91367 | 2019-09-13 |
| 1104381631 | Victor Fernando Tovar | Behavior Technician | 21600 Oxnard Street, Suite 1030, Woodland Hills, CA 91367 | 2019-02-08 |
| 1982173076 | Tefany Cheam | Behavioral Analyst | 216000 Oxnard St., Suite 1800, Woodland Hills, CA 91367 | 2018-11-19 |
| 1205301520 | Basso Pharmacy, Inc. | Pharmacy | 5952 & 5954 Fallbrook Avenue, Woodland Hills, CA 91367 | 2018-10-13 |
| 1255813523 | Annemarie Fine | Behavioral Analyst | 21609 Oxnard St Ste 1800, Woodland Hills, CA 91367 | 2018-09-04 |
| 1730661166 | Paige Sefton | Marriage & Family Therapist | 21333 Oxnard St., Woodland Hills, CA 91367 | 2018-09-01 |
| 1073095402 | Rosalia Hernandez | Behavioral Analyst | 21600 Oxnard St Ste, Woodland Hills, CA 91367 | 2018-09-01 |
| Find all providers in zip 91367 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316501844 | Arash Yazdani | Dentist | 22141 Ventura Blvd Ste 207, Woodland Hills, CA 91364-5733 | 2019-04-30 |
| 1932698479 | Naminik and Koshki Dds Inc | Dentist | 6325 Topanga Canyon Blvd Ste 322, Woodland Hills, CA 91367-2027 | 2018-05-09 |
| 1164949111 | Pegah Shayesteh Khorram | Dentist | 22233 Buena Ventura St, Woodland Hills, CA 91364-5007 | 2017-08-29 |
| 1528504222 | Ahdoot Dentistry, Inc. | Dentist | 6342 Fallbrook Ave Ste 202, Woodland Hills, CA 91367-1613 | 2017-01-18 |
| 1710438239 | Farzin Kohanfarsi | Dentist | 20218 Wells Dr, Woodland Hills, CA 91364-4730 | 2016-10-19 |
| 1558750190 | Gregory Turk Dds | Dentist | 6325 Topanga Canyon Blvd Ste 508, Woodland Hills, CA 91367-2047 | 2015-01-20 |
| 1043612856 | Warner Plaza Dental Group | Dentist | 5989 Topanga Canyon Blvd, Woodland Hills, CA 91367-3623 | 2014-09-23 |
| 1083053805 | Othman Sijlamassi | Dentist | 5366 Winnetka Ave, Woodland Hills, CA 91364-3551 | 2013-06-14 |
| 1306193222 | Asal Sedghi | Dentist | 4854 Alatar Dr, Woodland Hills, CA 91364-4329 | 2012-08-09 |
| 1043566284 | Martin H Mardirosian | Dentist | 20047 Chapter Dr, Woodland Hills, CA 91364-5669 | 2012-07-25 |
| Find all providers in WOODLAND HILLS | ||||
| City | WOODLAND HILLS |
| Zip Code | 91367 |
Please comment or provide details below to improve the information on DR. MALLORY K RUSSELL.
| 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.