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

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, DMD

Title

Owner

Phone

(904) 221-5678

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "816281",
            "state": "FL"
        }
    ],
    "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.