Individual provider Active NPI

Marcus E. Paul, DMD

  • General Practice Dentistry
  • Pensacola, FL
National Provider Identifier
1013910579
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7742 Issued in FL
Practice address
555 Brent LN
Pensacola, FL 32503-2044
Phone
(850) 474-0449
Fax
(866) 627-2715
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 7742 FL Primary

Addresses

Primary practice location

555 Brent LN
Pensacola, FL 32503-2044

Mailing address

555 Brent LN
Pensacola, FL 32503-2044
Phone (850) 474-0449

Other identifiers 4

IdentifierTypeStateIssuer
781936OtherDELTA DENTAL PROVIDER NUM
40817OtherFLATLANTIC DENTAL PROVIDER
781936OtherUNITED CONCORDIA PROVIDER
86824OtherBLUESHIELD PROVIDER NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161026003114 FL Order and Referring Only - DentistPractitioner - Dentist 2163700014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7742FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1013910579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BRENT LN",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032044",
            "telephone_number": "850-474-0449",
            "fax_number": "866-627-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BRENT LN",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032044",
            "telephone_number": "850-474-0449",
            "fax_number": "866-627-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MARCUS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "7742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL PROVIDER NUM",
            "identifier": "781936",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATLANTIC DENTAL PROVIDER",
            "identifier": "40817",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "781936",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD PROVIDER NUMBE",
            "identifier": "86824",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.