Stanley Bernard Marable, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN010910 Issued in GA

Practice address

308 Janet St
Valdosta, GA 31602-2602

Phone

(229) 244-5644

Fax

(229) 247-1412

NPI assigned

Jan 8, 2007

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295883957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 JANET ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022602",
            "telephone_number": "229-244-5644",
            "fax_number": "229-247-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 JANET ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022602",
            "telephone_number": "229-244-5644",
            "fax_number": "229-247-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARABLE",
        "first_name": "STANLEY",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9184102",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00043153B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101089",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twyla Lucinda Mancil, PH. D.
• Amrendra Kumar Mandal
• Tashari Shameka Manning
• Mafaz Mansoor, MD
• Alexis Marable
• Richard A Marasco, PHARM., FASCP, CGP
• Maegan Marcinowski, RBT
• Maria C Castellano, MD, LLC
• Mark a. Retterbush
• Mark a. Roland, DMD PC

• General Practice Dentistry in Valdosta, GA
• Providers in Valdosta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.