Individual provider Active NPI

Julio Marin Jr., DDS

  • Dentist
  • Slidell, LA
National Provider Identifier
1508244039
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6564 Issued in LA
Practice address
640 Brownswitch Rd
Slidell, LA 70458-1234
Phone
(985) 643-2828
Fax
(985) 643-2824
NPI assigned
May 17, 2015
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6564 LA Primary

Addresses

Primary practice location

640 Brownswitch Rd
Slidell, LA 70458-1234

Mailing address

640 Brownswitch Rd
Slidell, LA 70458-1234
Phone (985) 643-2828

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
6564LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Julio C Marin Jr DDS LLC CurrentSince Mar 12, 2024 Accepting new patients
Dr. Mark D. Anderson Past Accepting new patients
Pousson Family Dentistry, PLC PastSince Mar 12, 2024 Accepting new patients
Mid City Smiles Family Dentistry Past Accepting new patients

Locations

640 Brownswitch Rd
Slidell, LA 70458
Phone (985) 605-7632

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1508244039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 BROWNSWITCH RD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704581234",
            "telephone_number": "985-643-2828",
            "fax_number": "985-643-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 BROWNSWITCH RD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704581234",
            "telephone_number": "985-643-2828",
            "fax_number": "985-643-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "JULIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-17",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.