Marcus L Palermo, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DD3195 Issued in NM

Practice address

2100 Calle de la Vuelta
Suite C-102
Santa Fe, NM 87505-4742

Phone

(505) 988-3636

Fax

(505) 501-7557

NPI assigned

Jun 13, 2007

Last updated

Mar 28, 2012By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1285838391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CALLE DE LA VUELTA",
            "address_2": "SUITE C-102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-988-3636",
            "fax_number": "505-501-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CALLE DE LA VUELTA",
            "address_2": "SUITE C-102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054742",
            "telephone_number": "505-988-3636",
            "fax_number": "505-501-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "MARCUS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D7327",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NM",
            "license": "DD3195",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Page Nelson Marriage and Family Therapy Inc.
• Brittnee Page
• Stefanie Marie Page
• Autumn Pajarito
• Ivan Alexander Pale Hernandez
• Michael Dane Palestine, M.D.
• Vincent John Palladino, DC
• Leslie Palma
• Sheila M Palmer
• Zoe Palmer

• Endodontics in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Endodontics in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.