Mallori Watson, DMD is a medicare enrolled "Dentist" provider in Wallkill, New York. Her current practice location is
800 Red Mills Rd, Wallkill, New York. You can reach out to her office (for appointments etc.) via phone at
(919) 933-9087.
Mallori Watson is licensed to practice in New York (license number 056505) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417268038.
Healthcare Provider's Profile
Full Name | Mallori Watson |
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Gender | Female |
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Speciality | Dentist |
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Location | 800 Red Mills Rd, Wallkill, New York |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417268038
- Provider Enumeration Date: 06/29/2010
- Last Update Date: 08/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 8820216955
- Enrollment ID: I20230330001088
Medical Identifiers
Medical identifiers for Mallori Watson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417268038 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 9222 (North Carolina) | Secondary |
122300000X | Dentist | 056505 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mallori Watson allows following entities to bill medicare on her behalf.
Entity Name | Charlotte Community Health Clinic, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1528363868 PECOS PAC ID: 0840502274 Enrollment ID: O20150626001703 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mallori Watson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mallori Watson, DMD 800 Red Mills Rd, Wallkill, NY 12589-3220 Ph: () - | Mallori Watson, DMD 800 Red Mills Rd, Wallkill, NY 12589-3220 Ph: (919) 933-9087 |
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