IndividualActive
Mallory Edmondson, MSDH, RDH
NPI 1467920892 · Dental Hygienist · South Bend, IN
Provider details
- NPI number
- 1467920892
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Credential
- MSDH, RDH
- Sex
- Female
- Sole proprietor
- No
- License
- 13007311A (IN)
Specialties & taxonomies
Dental Providers
Practice location
1002 S Esther St
South Bend, IN 46615-1440
Phone: (219) 363-8866
Approximate (ZIP-level) locationGet directions
Mailing address
4511 N 600 E
Rolling Prairie, IN 46371-9511
Registry dates
- Enumerated
- 2018-11-03
- Last updated
- 2018-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.