Kurt Otto Marcks, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

42360 Issued in CA

Practice address

24099 Postal Ave
Suite 101
Moreno Valley, CA 92553-7709

Phone

(951) 601-1290

Fax

(951) 601-1292

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

Yes

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 CA

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 and National Provider Directory roles.

• Lynn Daz, D.D.S. ,Inc.

  dba Moreno Valley Endodontics

  • Endodontics
  • Moreno Valley, CA
  • NPI 1013697390
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487858106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24099 POSTAL AVE",
            "address_2": "SUITE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537709",
            "telephone_number": "951-601-1290",
            "fax_number": "951-601-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24099 POSTAL AVE",
            "address_2": "SUITE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537709",
            "telephone_number": "951-601-1290",
            "fax_number": "951-601-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCKS",
        "first_name": "KURT",
        "middle_name": "OTTO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "42360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathalie Saray Manriquez
• Mansfield Professional Medical Corporation
• Kat Manzo
• Sharina Mary Mapleton, D.O.
• Ambreen Maqsood
• Jesse Marez, LCSW
• Sarah Elizabeth Marfori
• Karra Marh
• Pamela Mariglia, LCSW
• Stephanie Celeste Marin

• Endodontics in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.