Marc Desjarlais, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D13172 Issued in MN

Practice address

3245 Hospital Dr
Juneau, AK 99801-7809

Phone

(907) 463-6652

NPI assigned

May 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Interoperability endpoints

• Direct secure messaging: m.desjarlais@brhwc.directbygreenway.com

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1194018747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017809",
            "telephone_number": "907-463-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017809",
            "telephone_number": "907-463-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARLAIS",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MN",
            "license": "D13172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Demmert
• Robin Jensena Demoski, RN
• Denali Mesa Corporation
• Larry B Depute, P.A.-C
• Derek J Larsen
• Charles Henry Detjen, DMD
• Diagnostic Radiology Consultants, PC
• Dialysis Services of Southeast Alaska LLC
• Bendick J Didrickson, CSFW
• Kwame Diehl, MSW

• Public Health Dentistry in Juneau, AK
• Providers in Juneau, AK by specialty
• Public Health Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.