MALLORI WATSON D.M.D.
NPI 1417268038
Dentist in Granbury, TX

Q: What is Mallori Watson's NPI number?

The NPI number for Mallori Watson is 1417268038. It was assigned to this individual provider in the NPPES registry on June 29, 2010.

Q: What is Mallori Watson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Mallori Watson was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2010PECOS Enrolled

3412 E US HIGHWAY 377, GRANBURY, TX 76049(601) 466-6933 Get Directions Write a Review

NPPES record last updated: February 19, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Feb 19, 2025, Aug 17, 2021 (2 updates tracked since 2021).

On this page

About Mallori Watson D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORI WATSON D.M.D. (NPI 1417268038) is an individual dentist in Granbury, Texas, licensed in Texas (41208) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417268038

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameMALLORI WATSONCredential: D.M.D.

Location Address3412 E US HIGHWAY 377Granbury, TX 76049-7418

Mailing Address3412 E Us Highway 377Granbury, TX 76049-7418

Phone(601) 466-6933

Sole ProprietorNo

Enumeration DateJune 29, 2010

Last NPPES UpdateFebruary 19, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 19, 2025

✔ NPI 1417268038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in TX · 41208✔ Licensed in NY · 056505✔ Licensed in NC · 9222

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

3412 E US HIGHWAY 377, Granbury, TX 76049

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallori Watson D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mallori Watson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Charlotte Community Health Clinic, Inc.

984 mi

Federally Qualified Health Center (FQHC)

5301 WILKINSON BLVD STE 1105
Charlotte, NC 28208

Reassigned Medicare billing, North Carolina enrollment
29 clinicians in this Medicare group

NPI 1215499520 (704) 316-6573

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76049 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CYNTHIA MALECKI KNIGHT D.D.S.

Dentist

3412 E US HIGHWAY 377
GRANBURY, TX 76049

Hood County (817) 573-3761

MELISSA R MCHANEY RDA

Dental Assistant

3412 E US HIGHWAY 377
GRANBURY, TX 76049

Hood County (817) 573-3761

DR. KELBY M OKADA D.M.D.

Dentist (General Practice)

3412 E US HIGHWAY 377
GRANBURY, TX 76049

Hood County (817) 776-8073

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallori Watson's NPI number?

The NPI number for Mallori Watson is 1417268038. It was assigned to this individual provider in the NPPES registry on June 29, 2010.

Where is Mallori Watson located?

Mallori Watson practices at 3412 E Us Highway 377, Granbury, TX 76049. The listed phone number is (601) 466-6933.

What is Mallori Watson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Mallori Watson enrolled in Medicare?

Yes. Mallori Watson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mallori Watson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mallori Watson reassigns Medicare benefits to Charlotte Community Health Clinic, Inc. (Charlotte, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mallori Watson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mallori Watson accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Cigna Healthcare and 8 other insurers list Mallori Watson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mallori Watson was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.