Marshal Dylan Earnest, DMD

Individual provider Active NPI General Practice Dentistry · Columbus, NC

NPI 1154858413 · NPPES record last updated Oct 11, 2023

Key facts

NPI
1154858413
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
11656 (NC)
Practice address
130 Forest Glen Rd
Columbus, NC 28722-3456
Phone
(828) 722-0003
Fax
(828) 333-5460
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190521002189 FL Order and Referring Only - Dentist
Practitioner - Dentist
3072856772

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
11656NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Hospital and Medical Center Past Accepting new patients
FL Dental Centers PLLC Past
since Jul 28, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN23051 FL
General Practice Dentistry 1223G0001X 11656 NC Yes

Addresses

Primary practice location

130 Forest Glen Rd
Columbus, NC 28722-3456

Mailing address

123 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 252-4290

Other practice location 1

123 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 252-4290

Other providers in Columbus, NC

All providers in Columbus, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.