Individual provider Active NPI

Marloin C Cummings, DDS

  • Pediatric Dentistry
  • Jacksonville, FL
National Provider Identifier
1467545087
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN23234 Issued in FL
Practice address
9000 Golfside Dr Ste a
Jacksonville, FL 32256-7793
Phone
(904) 737-8410
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN122206 GA
Pediatric Dentistry 1223P0221X DN23234 FL Primary

Addresses

Primary practice location

9000 Golfside Dr Ste a
Jacksonville, FL 32256-7793

Mailing address

9000 Golfside Dr Ste a
Jacksonville, FL 32256-7793
Phone (904) 737-8410

Other practice location 1

132 Southern Blvd
Savannah, GA 31405-7414
Phone (912) 600-1594

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

LicenseStateTypeSpecialty
DN23234FLMDPediatric Dentist
DN122206GAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1467545087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 GOLFSIDE DR STE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567793",
            "telephone_number": "904-737-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 GOLFSIDE DR STE A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567793",
            "telephone_number": "904-737-8410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314057414",
            "country_code": "US",
            "telephone_number": "912-600-1594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "MARLOIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN122206",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN23234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.