Martesia A Marshall, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

71949 Highway 111
#100B
Rancho Mirage, CA 92270-4826

Phone

(760) 565-6055

Fax

(760) 406-5068

NPI assigned

Apr 28, 2012

Last updated

Feb 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Pediatric Dental Associates PLLC

  • Pediatric Dentistry
  • Williamsville, NY
  • NPI 1144730649

  General Practice

  NPD (past)

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

{
    "created_epoch": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1043578966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71949 HIGHWAY 111",
            "address_2": "#100B",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704826",
            "telephone_number": "760-565-6055",
            "fax_number": "760-406-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71949 HIGHWAY 111",
            "address_2": "#100B",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704826",
            "telephone_number": "760-565-6055",
            "fax_number": "760-406-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MARTESIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-28",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012025A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark V Sofonio MD Inc (Plastic & Reconstructive Surgery & Laser Medical Center of the Desert)
• Courtney Marie Markey, R.D.N
• Keith M Markley, MD
• Elizabeth O. Marquart, M.D.
• Jose I. Marquez, M.D.
• Vahe Grigor Martikian, MD
• Reg'Shon Nathaniel Martin
• Reginald Daniel Martin Jr.
• Kelvin Martinez Garcia, MD
• Gisselle Martinez Vizcaya

• Student in an Organized Health Care Education/Training Program in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.

Verify at the official NPI Registry.