Active NPI
James D Marotzke, DDS
- General Practice Dentistry
- Lidgerwood, ND
National Provider Identifier
1376692756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1488
- Practice address
- 19 Wiley Ave. S.
Lidgerwood, ND 58053-0431 - Phone
- (701) 538-4583
- Fax
- (701) 538-4583
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1488 | ND | Primary |
Addresses
Primary practice location
19 Wiley Ave. S.
Lidgerwood, ND 58053-0431
Mailing address
19 Wiley Avenue South
Box 431
Lidgerwood, ND 58053-0431
Phone (701) 538-4583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lidgerwood Dental Office | Past | Accepting new patients | |
| Northcreek Dental PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Lidgerwood, ND
- NPI 1285043802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376692756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 WILEY AVENUE SOUTH",
"address_2": "BOX 431",
"city": "LIDGERWOOD",
"state": "ND",
"postal_code": "580530431",
"telephone_number": "701-538-4583",
"fax_number": "701-538-4583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 WILEY AVE. S.",
"city": "LIDGERWOOD",
"state": "ND",
"postal_code": "580530431",
"telephone_number": "701-538-4583",
"fax_number": "701-538-4583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAROTZKE",
"first_name": "JAMES",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ND",
"license": "1488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lidgerwood, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.