Active NPI
Steven Marinakis, DMD
- Dentist
- Boothwyn, PA
National Provider Identifier
1255438859
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 18, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS0019996L
- Practice address
- 3207 Chichester Ave
Boothwyn, PA 19061 - Phone
- (610) 485-9977
- Fax
- (610) 485-7030
- NPI assigned
- Sep 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS0019996L | PA | Primary |
Addresses
Primary practice location
3207 Chichester Ave
Boothwyn, PA 19061
Mailing address
3207 Chichester Ave
Boothwyn, PA 19061
Phone (610) 485-9977
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0019996L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255438859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3207 CHICHESTER AVE",
"city": "BOOTHWYN",
"state": "PA",
"postal_code": "19061",
"telephone_number": "610-485-9977",
"fax_number": "610-485-7030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3207 CHICHESTER AVE",
"city": "BOOTHWYN",
"state": "PA",
"postal_code": "19061",
"telephone_number": "610-485-9977",
"fax_number": "610-485-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINAKIS",
"first_name": "STEVEN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS0019996L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boothwyn, PA
- Jeff Quip, Inc. (The Home Care Network, Jefferson Health System - Rehab Equipment)
- Joel S. Goldberg
- Nancy Elizabeth Jordan, PT
- Manuel T. Lim, MD
- Issam Malkoun, OPTICIAN
- Timothy A Martin, D.C.
- Louis M. Micolucci, R.PH.
- Modern Dental Professionals Philadelpha PC (Pro-dent)
- Lauren Moyer, M.S., CCC-SLP
- Shaun T Mullan, CMT
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.