Mark a Tallis DDS Apdc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4456 Issued in LA

Legal business name

MARK A TALLIS DDS APDC

Practice address

5225 O Donovan Drive
Suite 103
Baton Rouge, LA 70808-4353

Phone

(225) 769-8555

Fax

(225) 766-8579

NPI assigned

Feb 12, 2007

Last updated

Jul 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Anthony Tallis, DDSNPI 1679936447

Title

President of S Corp Dentist Owner

Phone

(225) 769-8555

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Anthony Tallis, D.D.S.

  • General Practice Dentistry
  • Baton Rouge, LA
  • NPI 1679936447
  Authorized official Same address or phone

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1205978889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 O DONOVAN DRIVE",
            "address_2": "SUITE 103",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084353",
            "telephone_number": "225-769-8555",
            "fax_number": "225-766-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 O DONOVAN DRIVE",
            "address_2": "SUITE 103",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084353",
            "telephone_number": "225-769-8555",
            "fax_number": "225-766-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A TALLIS DDS APDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "TALLIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT OF S CORP DENTIST OWNER",
        "authorized_official_telephone_number": "225-769-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "4456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1844560",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marillac Community Health Centers (DePaul Community Health Centers - North Baton Rouge)
• Christina Marino, APRN, FNP-C
• Jennifer Anne Marino, P.T.
• Cherez Kailynn Marioneaux, LMT
• Patti Zeringue Marionneaux, RN
• Mark H. Zielinski, MD, LLC (Mark H Zielinski, MD)
• Mark Shoptaugh Jr. MD LLC
• Mark Shoptaugh, Jr., M.D., Psychiatry, L.L.C.
• Erica Mark
• Amy Kyger Markerson, PA-C

• General Practice Dentistry in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.