Active NPI
Marshall Allen Morris, DDS
- General Practice Dentistry
- Rochester, MN
National Provider Identifier
1184768681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D11095
- Practice address
- 1647 16TH Ave NW
Suite a
Rochester, MN 55901 - Phone
- (507) 282-4401
- Fax
- (507) 282-4407
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D11095 | MN | Primary |
Addresses
Primary practice location
1647 16TH Ave NW
Suite a
Rochester, MN 55901
Mailing address
5202 Southwood Drive SW
Rochester, MN 55902
Phone (507) 287-9002
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
| License | State | Type | Specialty |
|---|---|---|---|
| D11095 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnesota Lakes Dental, PLLC | General Practice | Current | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Rochester, MN
- NPI 1538765029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1184768681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5202 SOUTHWOOD DRIVE SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55902",
"telephone_number": "507-287-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1647 16TH AVE NW",
"address_2": "SUITE A",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55901",
"telephone_number": "507-282-4401",
"fax_number": "507-282-4407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "MARSHALL",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D11095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.