Active NPI
Connor Elise Marshall, DDS
- General Practice Dentistry
- Durant, OK
National Provider Identifier
1194337790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7648
- Practice address
- 1220 N Washington Ave
Durant, OK 74701-2120 - Phone
- (580) 745-5400
- Fax
- (405) 212-3066
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- 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 | 7648 | OK | Primary |
Addresses
Primary practice location
1220 N Washington Ave
Durant, OK 74701-2120
Mailing address
1548 Wildcat Dr
Portland, TX 78374-2814
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 |
|---|---|---|---|
| 7648 | OK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshall and Adams DDS, PLLC | General Practice | Current | Accepting new patients |
| Magnolia Smiles | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Anna, TX
- NPI 1013884469
-
- Dentist
- Durant, OK
- NPI 1669848891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1194337790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1548 WILDCAT DR",
"city": "PORTLAND",
"state": "TX",
"postal_code": "783742814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 N WASHINGTON AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747012120",
"telephone_number": "580-745-5400",
"fax_number": "405-212-3066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "CONNOR",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-17",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "7648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.