Active NPI
Robert Michael Marks, DDS
- Dentist
- Marlton, NJ
National Provider Identifier
1376717595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI00851000
- Practice address
- 475 Old Marlton Pike West
Marlton, NJ 08053-2098 - Phone
- (856) 596-4440
- NPI assigned
- Apr 18, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI00851000 | NJ | Primary |
| Periodontics | 1223P0300X | 2654 | NJ |
Addresses
Primary practice location
475 Old Marlton Pike West
Marlton, NJ 08053-2098
Mailing address
475 Old Marlton Pike West
Marlton, NJ 08053-2098
Phone (856) 596-4440
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI00851000 | NJ | MD | Dentist |
| 2654 | NJ | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1376717595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 OLD MARLTON PIKE WEST",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080532098",
"telephone_number": "856-596-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 OLD MARLTON PIKE WEST",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080532098",
"telephone_number": "856-596-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "ROBERT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-18",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI00851000",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "2654",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.