Marshall David Adzima, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418490 Issued in VA

Practice address

361 Walker Dr Ste 204
Warrenton, VA 20186-4364

Phone

(540) 341-4111

NPI assigned

Jun 8, 2023

Last updated

Jun 8, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason S Woodside DDS & Thomas C Sentz DDS, P.C.

  • General Practice Dentistry
  • Warrenton, VA
  • NPI 1992952600
  NPD (past)

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1356035638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 BUST HEAD RD",
            "city": "BROAD RUN",
            "state": "VA",
            "postal_code": "201371711",
            "telephone_number": "703-853-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 WALKER DR STE 204",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201864364",
            "telephone_number": "540-341-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADZIMA",
        "first_name": "MARSHALL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Warrenton, VA
• Providers in Warrenton, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.