Individual provider Active NPI

Jacqueline Ann Marcin, DMD

  • Dentist
  • York, PA
National Provider Identifier
1073511317
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5025765L Issued in PA
Practice address
1820 E Market St
York, PA 17402-2835
Phone
(717) 757-3851
Fax
(717) 840-1672
NPI assigned
Jul 11, 2005
Last updated
May 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D5025765L PA Primary

Addresses

Primary practice location

1820 E Market St
York, PA 17402-2835

Mailing address

1820 E Market St
York, PA 17402-2835
Phone (717) 757-3851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150514001162 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4385964378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
D5025765LPAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Market Street Dental, P.C. Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1073511317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022835",
            "telephone_number": "717-757-3851",
            "fax_number": "717-840-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022835",
            "telephone_number": "717-757-3851",
            "fax_number": "717-840-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCIN",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "D5025765L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.