Active NPI
Sung-Eun Lee Marshall, D.D.S.
- General Practice Dentistry
- Avondale, AZ
National Provider Identifier
1215272430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D011286
- Practice address
- 10210 W McDowell Rd Ste 140
Avondale, AZ 85392-4844 - Phone
- (480) 564-4981
- NPI assigned
- Nov 28, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 28539 | TX | |
| General Practice Dentistry | 1223G0001X | D011286 | AZ | Primary |
Addresses
Primary practice location
10210 W McDowell Rd Ste 140
Avondale, AZ 85392-4844
Mailing address
204 N Bronco Cir
Payson, AZ 85541-4297
Phone (323) 616-5996
Other practice location 1
1100 Lowes Blvd
Killeen, TX 76542-5491
Phone (254) 449-8163
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | na | Direct |
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 |
|---|---|---|---|
| D011286 | AZ | MD | General Practice Dentistry |
| 28539 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1215272430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 N BRONCO CIR",
"city": "PAYSON",
"state": "AZ",
"postal_code": "855414297",
"telephone_number": "323-616-5996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10210 W MCDOWELL RD STE 140",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853924844",
"telephone_number": "480-564-4981"
}
],
"practiceLocations": [
{
"address_1": "1100 Lowes Blvd",
"address_purpose": "LOCATION",
"city": "Killeen",
"state": "TX",
"postal_code": "765425491",
"country_code": "US",
"telephone_number": "254-449-8163",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARSHALL",
"first_name": "SUNG-EUN",
"middle_name": "LEE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-28",
"last_updated": "2022-05-19",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "28539",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D011286",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "na",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "10210 W McDowell Rd Ste 140",
"city": "Avondale",
"state": "AZ",
"country_code": "US",
"postal_code": "853924844",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.