Individual provider Active NPI

Eduardo Marquez, D.M.D.

  • General Practice Dentistry
  • Altoona, PA
National Provider Identifier
1063567865
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS035543 Issued in PA
Practice address
1913 E Pleasant Valley Blvd
Suite #3
Altoona, PA 16602-7509
Phone
(814) 942-7686
Fax
(814) 942-7801
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

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 DS035543 PA Primary

Addresses

Primary practice location

1913 E Pleasant Valley Blvd
Suite #3
Altoona, PA 16602-7509

Mailing address

1913 E Pleasant Valley Blvd
Suite #3
Altoona, PA 16602-7509
Phone (814) 942-7686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS035543PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1063567865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 E PLEASANT VALLEY BLVD",
            "address_2": "SUITE #3",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166027509",
            "telephone_number": "814-942-7686",
            "fax_number": "814-942-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 E PLEASANT VALLEY BLVD",
            "address_2": "SUITE #3",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166027509",
            "telephone_number": "814-942-7686",
            "fax_number": "814-942-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "EDUARDO",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.