Individual provider Active NPI

Alexander Thomas Marlow, DMD

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1003254285
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020980 Issued in MI
Practice address
2365 S Huron Pkwy
Ann Arbor, MI 48104-5156
Phone
(734) 677-8700
Fax
(734) 839-4137
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020980 MI Primary

Addresses

Primary practice location

2365 S Huron Pkwy
Ann Arbor, MI 48104-5156

Mailing address

2365 S Huron Pkwy
Ann Arbor, MI 48104-5156
Phone (734) 677-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160727001797 MI Order and Referring Only - DentistPractitioner - Dentist 9133419591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Marzonie Gray & Associates PLLC CurrentSince Oct 19, 2020 Accepting new patients
Apnea Alternatives PastSince Oct 11, 2020 Accepting new patients
Fireberg Family Dental LLC Past Accepting new patients

Locations

2900 Golfside Dr
Ste 6
Ann Arbor, MI 48108
Phone (734) 224-9121

2365 S Huron Pkwy
Ann Arbor, MI 48104
Phone (734) 677-1810

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1003254285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 S HURON PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045156",
            "telephone_number": "734-677-8700",
            "fax_number": "734-839-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 S HURON PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045156",
            "telephone_number": "734-677-8700",
            "fax_number": "734-839-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLOW",
        "first_name": "ALEXANDER",
        "middle_name": "THOMAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.