Marcia R Dettloff, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1183 Issued in NC

Practice address

160 NE Maynard Rd
Suite 110
Cary, NC 27513

Phone

(919) 439-7995

Fax

(919) 415-0422

NPI assigned

Aug 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Triangle Health Solutions PLLC

  • Clinic/Center
  • Cary, NC
  • NPI 1306720974
  NPD

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1265434617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NE MAYNARD RD",
            "address_2": "SUITE 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-439-7995",
            "fax_number": "919-415-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NE MAYNARD RD",
            "address_2": "SUITE 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-439-7995",
            "fax_number": "919-415-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTLOFF",
        "first_name": "MARCIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC PROVIDER NUMBER",
            "identifier": "093TF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colby Luise Deshields
• Michael Joseph Desimone
• Kati Elizabeth Dessauer, M.D.
• Hilaire Desty
• Nazahe Z Desuse
• Kristi Sue Devaul
• Devonza Nanette Deviner
• Kristen Dewey, LCSW
• Kyndra Dewitt
• Mani Dexter, LMFTA

• Optometrist in Cary, NC
• Providers in Cary, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.