Individual provider Active NPI

Gregg Allan Marr, D.D.S.

  • General Practice Dentistry
  • Saint Joseph, MI
National Provider Identifier
1245391481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10452 Issued in MI
Practice address
455 Upton Dr
Saint Joseph, MI 49085-1058
Phone
(269) 983-7881
Fax
(269) 983-7871
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 10452 MI Primary

Addresses

Primary practice location

455 Upton Dr
Saint Joseph, MI 49085-1058

Mailing address

50401 Bond Rd
Decatur, MI 49045-9449
Phone (269) 423-7287

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
10452MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245391481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50401 BOND RD",
            "city": "DECATUR",
            "state": "MI",
            "postal_code": "490459449",
            "telephone_number": "269-423-7287",
            "fax_number": "269-983-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 UPTON DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851058",
            "telephone_number": "269-983-7881",
            "fax_number": "269-983-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARR",
        "first_name": "GREGG",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "10452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.