Marc J Meadows DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010415 Issued in IN

Legal business name

MARC J MEADOWS DDS PC

Practice address

515 S Woodscrest Dr
Bloomington, IN 47401-5524

Phone

(812) 332-0866

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Lisa Marie Meadows

Title

Business Manager

Phone

(812) 332-0866

Specialties & licenses 1

Addresses

Other names 1

• Woodscrest Dental Doing business as

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1114016201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S WOODSCREST DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015524",
            "telephone_number": "812-332-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S WOODSCREST DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015524",
            "telephone_number": "812-332-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC J MEADOWS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "MEADOWS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "812-332-0866"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodscrest Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ross Manning, LCSW
• Cheryl Lynn Mansell, MSW LCSW
• Alex Manuel, MD
• Bettina R Manuel, CCC-SLP
• Marabai Rose Counseling, LLC
• Nicole Mardirossian
• James G Marencik, MD
• Heather Leigh Maritano, LCSW, RPT-S
• Mark a. Herrmann, PH.D., P.C.
• Valerie Markley, DNP, PMHCNS-BC

• General Practice Dentistry in Bloomington, IN
• Providers in Bloomington, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.