Individual provider Active NPI

Marlene Helen Schiller, DDS

  • General Practice Dentistry
  • Odessa, TX
National Provider Identifier
1053516161
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11734 Issued in TX
Practice address
4101 East 42ND
Ste B23 #27
Odessa, TX 79762
Phone
(432) 363-4867
Fax
(432) 363-1799
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 11734 TX Primary

Addresses

Primary practice location

4101 East 42ND
Ste B23 #27
Odessa, TX 79762

Mailing address

4101 East 42ND
Ste B23 #27
Odessa, TX 79762

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
I20181219001688 TX Order and Referring Only - DentistPractitioner - Dentist 3072858059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11734TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Odessa Mall FDC PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053516161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 EAST 42ND",
            "address_2": "STE B23 #27",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 EAST 42ND",
            "address_2": "STE B23 #27",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79762",
            "telephone_number": "432-363-4867",
            "fax_number": "432-363-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLER",
        "first_name": "MARLENE",
        "middle_name": "HELEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "11734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.