Individual provider Active NPI

Christopher John Marzonie, DDS

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1205916939
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12824 Issued in MI
Practice address
2365 South Huron Parkway
Ann Arbor, MI 48104-5156
Phone
(734) 677-8700
Fax
(734) 839-4137
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12824 MI Primary

Addresses

Primary practice location

2365 South Huron Parkway
Ann Arbor, MI 48104-5156

Mailing address

2365 S Huron Pkwy
Ann Arbor, MI 48104-5156
Phone (734) 677-8700

Other practice location 1

1795 W Stadium
Ann Arbor, MI 48103-4810
Phone (734) 662-3222

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

LicenseStateTypeSpecialty
12824MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Marzonie Gray & Associates PLLC Dentist CurrentSince Nov 8, 2020 Accepting new patients
Apnea Alternatives Dentist CurrentSince Nov 8, 2020 Accepting new patients
Ann Arbor Smiles Haddock PLLC Dentist PastSince Sep 6, 2020 Accepting new patients

Locations

2900 Golfside Dr
Ste 6
Ann Arbor, MI 48108
Phone (734) 224-9121

2365 S Huron Pkwy
Ste B
Ann Arbor, MI 48104
Phone (734) 677-8700

2365 S Huron Pkwy
Ann Arbor, MI 48104
Phone (734) 677-1810

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1205916939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 S HURON PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045156",
            "telephone_number": "734-677-8700",
            "fax_number": "734-839-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 SOUTH HURON PARKWAY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045156",
            "telephone_number": "734-677-8700",
            "fax_number": "734-839-4137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1795 W Stadium",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481034810",
            "country_code": "US",
            "telephone_number": "734-662-3222",
            "fax_number": "734-839-4137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARZONIE",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.