Marshall Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34163 Issued in CA

Legal business name

MARSHALL DENTAL GROUP

Practice address

6200 Wilshire Blvd
#1709
Los Angeles, CA 90048-5801

Phone

(323) 634-6334

Fax

(323) 634-6338

NPI assigned

Jul 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Derek Spencer Marshall Sr., DDS

Title

Owner

Phone

(323) 634-6334

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1508065715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "#1709",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-634-6334",
            "fax_number": "323-634-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "#1709",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-634-6334",
            "fax_number": "323-634-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-634-6334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa Marshak, M.S., CCC-SLP
• Herbert Marshak, MD
• Sidney Marshak, M.D.
• Marshal P Fichman MD a Professional Corp
• Marshall B. Ketchum University/University Eye Center at Los Angeles
• Marshall Jay Keyes M D a Medical Corporation
• Marshall L. Grode, M.D a Professional Corporation
• Andre Orlando Marshall, RPFT
• Austin Anand Marshall, MD
• Brandon Lamont Marshall

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.