Marvin Leif Stromberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9126 Issued in TX

Practice address

1800 S Pacific St
Mineola, TX 75773-2800

Phone

(903) 569-5569

Fax

(903) 569-1601

NPI assigned

Oct 20, 2015

Last updated

Dec 1, 2015By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake View Dental Center

  • Dental Clinic/Center
  • Mineola, TX
  • NPI 1699953349
  NPD (past)

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1427420215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3870 WHITEHALL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752292756",
            "telephone_number": "214-358-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S PACIFIC ST",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757732800",
            "telephone_number": "903-569-5569",
            "fax_number": "903-569-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROMBERG",
        "first_name": "MARVIN",
        "middle_name": "LEIF",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "9126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah C Sitton, ANP
• Nancy Renee Smith, LPC
• Adam Solomon, DDS
• Roger Paul Stai, RPH
• Stratford Hospital District (Caraday of Mineola)
• Dylan James Sutton, DO
• Brianna Nicole Teaff, DC
• Hayley Teal, RD
• Texas Bluebonnet Home Care Inc (Bluebonnet Home Care)
• Therapy With Autumn

• General Practice Dentistry in Mineola, TX
• Providers in Mineola, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.