Marc C Van Tassell, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

4743125-9922 Issued in UT

Practice address

1304 E Aultman St
Ely, NV 89301-2513

Phone

(775) 289-6166

NPI assigned

Feb 7, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255303723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 E AULTMAN ST",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893012513",
            "telephone_number": "775-289-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 E AULTMAN ST",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893012513",
            "telephone_number": "775-289-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSELL",
        "first_name": "MARC",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "4743125-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Therapy Services LLC
• Nasir Uddin, M.D.
• University of Utah Adult Services (WILLIAM RIRIE HOSPITAL-Cardiology)
• University of Utah Adult Services (WILLIAM RIRIE HOSPITAL-EP Cardiology)
• Jesse W. Valadez, D.C.
• Ha Viet Vu, MD
• W H Gallimore DO PLLC
• Matthew F Walker, PHARMD
• Rosemarie Wallace
• Jessica Wayman

• Dentist in Ely, NV
• Providers in Ely, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.