Selena L Marchan, DMD, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN13459 Issued in FL

Legal business name

SELENA L MARCHAN, DMD, PA

Practice address

13475 Atlantic Blvd
Ste 36
Jacksonville, FL 32225-3291

Phone

(904) 246-2603

Fax

(904) 247-9663

NPI assigned

Nov 13, 2007

Last updated

Mar 1, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Selena L Marchan, DMDNPI 1649380932

Title

Owner

Phone

(904) 221-5678

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Selena Loterina Marchan, DMD

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1649380932
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425168000000",
    "number": "1003096579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13475 ATLANTIC BLVD STE 36",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253290",
            "telephone_number": "904-221-5678",
            "fax_number": "904-220-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13475 ATLANTIC BLVD",
            "address_2": "STE 36",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253291",
            "telephone_number": "904-246-2603",
            "fax_number": "904-247-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELENA L MARCHAN, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2015-03-01",
        "status": "A",
        "authorized_official_last_name": "MARCHAN",
        "authorized_official_first_name": "SELENA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-221-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.