Active NPI
Marcus E. Paul, DMD
- General Practice Dentistry
- Pensacola, FL
National Provider Identifier
1013910579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7742
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 781936 | Other | DELTA DENTAL PROVIDER NUM | |
| 40817 | Other | FL | ATLANTIC DENTAL PROVIDER |
| 781936 | Other | UNITED CONCORDIA PROVIDER | |
| 86824 | Other | BLUESHIELD 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161026003114 | FL | Order and Referring Only - Dentist | 2163700014 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7742 | FL | MD | General 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.