Individual provider Active NPI

Lauryn E Marks, DMD

  • General Practice Dentistry
  • McMinnville, OR
National Provider Identifier
1205212479
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10297 Issued in OR
Practice address
510 NE 8TH St
McMinnville, OR 97128-3910
Phone
(503) 472-3147
NPI assigned
Aug 10, 2015
Last updated
Aug 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10297 OR Primary

Addresses

Primary practice location

510 NE 8TH St
McMinnville, OR 97128-3910

Mailing address

1401 E 2ND St Unit B
Newberg, OR 97132-3254
Phone (505) 917-2675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20151217000422 OR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0345541371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10297ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1205212479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 2ND ST UNIT B",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971323254",
            "telephone_number": "505-917-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NE 8TH ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283910",
            "telephone_number": "503-472-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "LAURYN",
        "middle_name": "E",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.