CHARLES BRENT MALLIN


Address: 8000 Bonhomme Ave Ste 401, Suite 401, Clayton, MO 63105-3515
Phone: 3147272288

CHARLES BRENT MALLIN (NPI# 1750573960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750573960
Entity Type Individual
Full Name CHARLES BRENT MALLIN
Credential D.D.S.
Practice Address 8000 Bonhomme Ave Ste 401
Suite 401
Clayton
MO 63105-3515
Practice Telephone 3147272288
Practice Fax Number 3147272285
Mailing Telephone 3147272288
Mailing Fax Number 3147272285
Enumeration Date 2007-08-11
Last Update Date 2007-08-11
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
11962 MO Dental Providers

Office Location

Street Address 8000 BONHOMME AVE STE 401
SUITE 401
City CLAYTON
State MO
Zip Code 63105-3515

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861016545 Amy Piontek Registered Nurse Habif Health and Wellness Center, 6643 Shepley Drive, St. Louis, MO 63105 2020-05-29
1427520634 Justin Kelly Chiropractor 8011 Maryland Avenue, St. Louis, MO 63105 2018-12-28
1720576663 St. Louis Center for Cognitive Health, LLC Clinic/Center 7711 Bonhomme Ave Ste 350, Clayton, MO 63105 2018-04-26
1457849317 A Storied Life Counseling LLC Social Worker 8000 Bonhomme Ave Ste 321, Clayton, MO 63105 2018-04-26
1669984142 Peter Bogart Counselor 7710 Carondelet, Suite #204, Saint Louis, MO 63105 2017-10-24
1356891162 Medical West Respiratory Pharmacy, LLC Pharmacy 440 South Brentwood Blvd, Clayton, MO 63105 2016-10-05
1710435565 James Breihan Occupational Therapist 401 Corporate Park Drive, Clayton, MO 63105 2016-09-21
1730566928 Frank Theus Counselor 7710 Carondelet Ave Ste 220, Saint Louis, MO 63105 2015-04-27
1962895896 John B Martin Obstetrics & Gynecology 312 N. Meramec #300, St. Louis, MO 63105 2015-03-17
1861814261 Jesse Marie Civello Physical Therapist 222 S Meramec Avenue, Suite 100, Clayton, MO 63105 2014-01-20
Find all providers in zip 63105

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326577602 Matthew Barnes Dentist 660 Nc-42, Clayton, NC 27520 2017-06-08
1790231231 Debra Peterson Dentist 32 Atchinson Stage Ct, Clayton, CA 94517-1101 2016-08-25
1831447259 David P. Cartago Dds, Dental Office, Inc. Dentist 1026 Oak St Ste 202, Clayton, CA 94517-1363 2012-08-15
1578824488 Matthew J Grabowski Dentist 100 Pinecroft Dr, Clayton, NC 27520-6923 2012-06-06
1053683979 Stephanie Lynn Brown Dentist 964 Nc Highway 42 W, Clayton, NC 27520-7434 2012-02-08
1295029163 Victor Duc Truong Dentist 6200 Center St, Suite I, Clayton, CA 94517-1446 2011-06-08
1598961690 John Clifford Tomasheski Dentist 31 Oleander Dr, Clayton, NC 27527-4561 2007-06-25
1275672875 Wesley Turner Funk Dentist 608 Highway 76 West, Clayton, GA 30525-0031 2007-02-06
1245382936 Jason Wayne Mullen Dentist 100 Pinecroft Dr., Clayton, NC 27520 2007-01-16
1194801852 Riccobene Flowers Dentist 31 Oleander Drive, Clayton, NC 27527 2006-10-27
Find all providers in CLAYTON

Competitor

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City CLAYTON
Zip Code 63105

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Dataset Information

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.

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