Individual provider Active NPI

Thomas Wayne Marshall, D.D.S.

  • General Practice Dentistry
  • McKinney, TX
National Provider Identifier
1356567259
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18336 Issued in TX
Practice address
2411 Virginia Pkwy
Suite 2
McKinney, TX 75071-3508
Phone
(972) 540-2800
Fax
(972) 542-1182
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18336 TX Primary

Addresses

Primary practice location

2411 Virginia Pkwy
Suite 2
McKinney, TX 75071-3508

Mailing address

2411 Virginia Pkwy
Suite 2
McKinney, TX 75071-3508
Phone (972) 540-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20150617001305 TX Order and Referring Only - DentistPractitioner - Dentist 2466763453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18336TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Dental Care of TX, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356567259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 VIRGINIA PKWY",
            "address_2": "SUITE 2",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750713508",
            "telephone_number": "972-540-2800",
            "fax_number": "972-542-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 VIRGINIA PKWY",
            "address_2": "SUITE 2",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750713508",
            "telephone_number": "972-540-2800",
            "fax_number": "972-542-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "THOMAS",
        "middle_name": "WAYNE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.