Marco a Tauil DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MARCO A TAUIL DDS, PC

Practice address

2340 S Commerce Rd Ste 1
Walled Lake, MI 48390-2174

Phone

(248) 624-0676

NPI assigned

Jan 4, 2021

Organization subpart

No

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

Authorized official

Name

Oxana Vardan

Title

Credentialing Specialist

Phone

(248) 403-9256

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rick Jerome Deroven, DDS

  • Dentist
  • Walled Lake, MI
  • NPI 1982627105
  NPD (past)

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1497343685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 S COMMERCE RD STE 1",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902174",
            "telephone_number": "248-624-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 S COMMERCE RD STE 1",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902174",
            "telephone_number": "248-624-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCO A TAUIL DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "VARDAN",
        "authorized_official_first_name": "OXANA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "248-403-9256"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghadeer Makki
• Marie Helene Malec
• David Maloney
• Susan A Maloney
• Elizabeth Ann Manela, SLP CCC
• Beth Maroko, RPH.
• Elizabeth Kathryn Martin, NP
• Lisa Ann Martin
• David Hugh McAree, MD
• Kari McAvoy, N.P.

• General Practice Dentistry in Walled Lake, MI
• Providers in Walled Lake, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.