Blaire L Marshall, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN1858554 Issued in MA

Practice address

Mansfield Modern Dentistry
287 School St Ste 120
Mansfield, MA 02048-0204

Phone

(918) 640-8209

NPI assigned

Jul 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dental Health Associates of Texas, PC.

  • General Practice Dentistry
  • Cypress, TX
  • NPI 1659693331
  NPD (past)

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1184989782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17515 SPRING CYPRESS RD STE I",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774292689",
            "telephone_number": "281-304-4280",
            "fax_number": "281-304-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MANSFIELD MODERN DENTISTRY",
            "address_2": "287 SCHOOL ST STE 120",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020480204",
            "telephone_number": "918-640-8209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17515 Spring Cypress Rd Ste I",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774292689",
            "country_code": "US",
            "telephone_number": "281-304-4280",
            "fax_number": "281-304-4286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "BLAIRE",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858554",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mansfield Physical Therapy Inc
• Mansfield Public Schools
• Salim A Mansour, OD
• Melanie Markir
• Meredith R Maroney, PHD
• Jennifer Brooke Martell, FNP-C
• Dawn Martin, LICSW
• Raymond Kirk Martin, D.D.S.,M.A.G.D.
• Mark John Mascheri, PT, DPT
• Jamie Mashiah

• Dentist in Mansfield, MA
• Providers in Mansfield, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.