Marvin C Koonce DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS2322 Issued in TN

Legal business name

MARVIN C KOONCE DDS PC

Practice address

603 N Main St
Shelbyville, TN 37160-3210

Phone

(931) 684-2445

Fax

(931) 684-6201

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Marvin C Koonce, DDSNPI 1184805731

Title

President

Phone

(931) 684-2445

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marvin Clay Koonce, DDS

  • General Practice Dentistry
  • Shelbyville, TN
  • NPI 1184805731
  NPD (past) Authorized official
• Kenneth Bradley Beard, DDS

  • General Practice Dentistry
  • Shelbyville, TN
  • NPI 1184865156
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396880480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371620741",
            "telephone_number": "931-684-2445",
            "fax_number": "931-684-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N MAIN ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603210",
            "telephone_number": "931-684-2445",
            "fax_number": "931-684-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN C KOONCE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOONCE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-684-2445",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS2322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ann Marchetti
• Heather Markum, OTR/L
• Jacquelynn Donette Marlowe
• Gerald Thomas Martin, D.D.S.
• Robert Timothy Martin
• Marvo C. Odds, DDS, P.C.
• Jessica Renea Massingille
• Penny Marie Matthews, FNP-C
• Kelly Lynn Mattingly
• Francietta Darice Mayberry, C.N.A.

• General Practice Dentistry in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.