Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Johnathan Lewis Mallott, DDS

Individual provider Dentist · NPI 1730260738

Dr. Johnathan Lewis Mallott, DDS is a Dentist in Columbia, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

3320 Bluff Creek Dr Ste 100
Columbia, MO 65201
Phone: (573) 874-2433
Fax: (573) 442-6525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 2003012136 (MO)

Record details

NPI number1730260738
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedOctober 17, 2006
Last updated in NPPESDecember 21, 2021
Certification dateDecember 21, 2021
Mailing address3320 Bluff Creek Dr., Suite 100, Columbia, MO 65201

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