Mallory Jo Nyenhuis, DDS in Flagstaff, AZ - Medicare Dentist Provider

Mallory Jo Nyenhuis, DDS is a medicare enrolled "Dentist" provider in Flagstaff, Arizona. Her current practice location is 223 N San Francisco St Ste 104, Flagstaff, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 275-1252.

Mallory Jo Nyenhuis is licensed to practice in Arizona (license number D011313) 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 1437503364.

Contact Information

	Mallory Jo Nyenhuis, DDS
	223 N San Francisco St Ste 104, Flagstaff, AZ 86001-4657
	(928) 275-1252
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mallory Jo Nyenhuis
Gender	Female
Speciality	Dentist
Location	223 N San Francisco St Ste 104, Flagstaff, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1437503364
Provider Enumeration Date: 04/18/2016
Last Update Date: 02/13/2025

Medicare PECOS Information:

PECOS PAC ID: 2365988060
Enrollment ID: I20250221002540

Medical Identifiers

Medical identifiers for Mallory Jo Nyenhuis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1437503364	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	D011313 (Arizona)	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. Mallory Jo Nyenhuis allows following entities to bill medicare on her behalf.

Entity Name	North Country Healthcare Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073583472 PECOS PAC ID: 8820981053 Enrollment ID: O20040210001107

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. Mallory Jo Nyenhuis 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
Mallory Jo Nyenhuis, DDS 2756 W Highland Meadows Dr, Williams, AZ 86046-9179 Ph: (920) 918-0843	Mallory Jo Nyenhuis, DDS 223 N San Francisco St Ste 104, Flagstaff, AZ 86001-4657 Ph: (928) 275-1252

Reviews and Comments

Dentist in Flagstaff, AZ

Dr. Richard J. Shannon, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1251 W University Ave, Flagstaff, AZ 86001 Phone: 928-214-0772 Fax: 928-214-0773
Dr. William Charles Gaylord, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 713 N Beaver St, Flagstaff, AZ 86001 Phone: 928-774-0881 Fax: 928-774-2029
Dr. Owen J Hibbert, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 315 W Cherry Ave, Flagstaff, AZ 86001 Phone: 928-774-4199
Thomas T Barnes, DDS Dentist Medicare: Medicare Enrolled Practice Location: 2500 N Rose St, Flagstaff, AZ 86004 Phone: 928-213-6121
David W Ho, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1024 N San Francisco St Ste 101, Flagstaff, AZ 86001 Phone: 928-779-0385 Fax: 928-779-6487
Brandon John Tilts, DDS Dentist Medicare: Medicare Enrolled Practice Location: 518 N Beaver St, Suite A, Flagstaff, AZ 86001 Phone: 928-774-4705 Fax: 928-213-9665
Dr. Vaughn Milton Oliver, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1953 E Y X Ranch Rd, Flagstaff, AZ 86001 Phone: 928-774-0586

Mallory Jo Nyenhuis, DDS - Medicare Dentist in Flagstaff, AZ