Marilyn McComb, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

S6-35C Issued in NV

Practice address

1022 Nevada Hwy
Suite 200
Boulder City, NV 89005-1825

Phone

(702) 580-4509

Fax

(702) 800-5441

NPI assigned

Dec 19, 2016

Last updated

Dec 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1427593987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60036",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890060036",
            "telephone_number": "702-765-0041",
            "fax_number": "702-800-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 NEVADA HWY",
            "address_2": "SUITE 200",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051825",
            "telephone_number": "702-580-4509",
            "fax_number": "702-800-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMB",
        "first_name": "MARILYN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-35C",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DC",
            "license": "5166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Marie Lyons I, OTR/L, CPAM
• Cynthia Madison
• Kristine Marie Maier, ACSW, LCSW
• Galina Marine, FNP-C
• Kelley McClellan
• Linda McCracken
• Elijah Lee McDonald
• Matthew David McGrandy
• John Glenn McLachlan, APRN FNP
• Meaningful Gains Therapy LLC

• Pediatric Dentistry in Boulder City, NV
• Providers in Boulder City, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.