Individual provider Active NPI

Emil Marx, DDS

  • Periodontics
  • Weston, FL
National Provider Identifier
1003586231
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
37816 Issued in TX
Practice address
16252 Laurel Dr Ste 101
Weston, FL 33326-1681
Phone
(972) 900-0051
NPI assigned
Sep 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 37816 TX Primary

Addresses

Primary practice location

16252 Laurel Dr Ste 101
Weston, FL 33326-1681

Mailing address

16252 Laurel Dr Ste 101
Weston, FL 33326-1681
Phone (972) 900-0052

Other identifiers 1

IdentifierTypeStateIssuer
M6252214784630OtherFLDRIVERS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240809000419 TX Order and Referring Only - DentistPractitioner - Dentist 5890232763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • TX HMO D-SNP
  • NM HMO C-SNP

NPI Registry JSON

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003586231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16252 LAUREL DR STE 101",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261681",
            "telephone_number": "972-900-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16252 LAUREL DR STE 101",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261681",
            "telephone_number": "972-900-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "EMIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-19",
        "last_updated": "2022-07-21",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "37816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "M6252214784630",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.