Henry Marcantoni, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

18386 Issued in TX

Practice address

10801 N Mo Pac Expy
BLDG. 2 Ste.130
Austin, TX 78759-5459

Phone

(512) 372-6230

Fax

(512) 372-6233

NPI assigned

Dec 12, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Salute Oral and Facial Surgery, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Austin, TX
  • NPI 1255521837
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1407917800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 N MO PAC EXPY",
            "address_2": "BLDG. 2 STE.130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595459",
            "telephone_number": "512-372-6230",
            "fax_number": "512-372-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 N MO PAC EXPY",
            "address_2": "BLDG. 2 STE.130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595459",
            "telephone_number": "512-372-6230",
            "fax_number": "512-372-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCANTONI",
        "first_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "18386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "202376140",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175391501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175392302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "18386",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "B18386",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Yaretzy Maravilla
• Marble Falls Dental PLLC
• Donald Marburg
• Marc Amsili DDS PA
• Kaitlyn Brianna Marcak
• Seanna Marceaux, MS RDN LD
• Robert Lee March, M.D.
• Melissa Marchan-Martinez, MD
• Marie Nicole Marchant, M.S., CCC-SLP
• Justin Raymond Marchegiani, D.C.

• Oral and Maxillofacial Surgery (Dentist) in Austin, TX
• Providers in Austin, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; 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.