Individual provider Active NPI

Drew E Marketto, DDS

  • Dentist
  • Las Cruces, NM
National Provider Identifier
1134578313
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4522 Issued in NM
Practice address
1600 Thorpe Rd
Las Cruces, NM 88012-9776
Phone
(575) 382-9292
Fax
(575) 382-2061
NPI assigned
Jun 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4522 NM Primary

Addresses

Primary practice location

1600 Thorpe Rd
Las Cruces, NM 88012-9776

Mailing address

PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20160804001400 NM Order and Referring Only - DentistPractitioner - Dentist 7113211731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1134578313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 THORPE RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880129776",
            "telephone_number": "575-382-9292",
            "fax_number": "575-382-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKETTO",
        "first_name": "DREW",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.