Kenneth Reid Marsh, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8579 Issued in NC

Practice address

1582 Hwy 56
Creedmoor, NC 27522

Phone

(919) 528-1980

Fax

(919) 528-8610

NPI assigned

May 28, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Practice roles

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.

• Kenneth R Marsh DDS PA

  • Dentist
  • Creedmoor, NC
  • NPI 1548445646
  NPD (past) Authorized official

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1285892174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275220596",
            "telephone_number": "919-528-8610",
            "fax_number": "919-528-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1582 HWY 56",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "27522",
            "telephone_number": "919-528-1980",
            "fax_number": "919-528-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "KENNETH",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909754",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wenli Liu
• Janelle Lynn Lopez-Wright, PA-C
• Jennifer Leah Mahoney, RN, MSN, FNP
• Alethea Samone Marcellus, MS, PSYCH, ACAS,ITFS
• Tammy Faith Margeson, LPCA, LCASA
• Keshawn S Mathews
• Mahkal L Mathews, LCMHC-A, LCAS-A
• Telina Faye Mathews, MA, LPC
• Kacey McHoney
• Nisha Panjwani Mehta, OD

• Dentist in Creedmoor, NC
• Providers in Creedmoor, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.