Derek Thomas Marks, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3619 Issued in AR

Practice address

3310 Highway 5 North
Bryant, AR 72022

Phone

(501) 847-7070

NPI assigned

Jul 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Marks Children'S Dentistry

  • Pediatric Dentistry
  • Bryant, AR
  • NPI 1366639585
  NPD Authorized official

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1033318068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 HIGHWAY 5 NORTH",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "telephone_number": "501-847-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 HIGHWAY 5 NORTH",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "telephone_number": "501-847-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "DEREK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164860608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Kate Malmstrom
• Robert Maltby, PHARM D
• Moriah Manchack, CCC-SLP
• Madelene Bangalan Marcon, BCBA
• Marks Children'S Dentistry
• Jaranimo Marks
• Jayla McKenzie Marks
• Khandajah Marks
• Kristin Leigh Marling
• Leigh Truemper Marlow

• Pediatric Dentistry in Bryant, AR
• Providers in Bryant, AR by specialty
• Pediatric Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.