NPIMap

Organization Active NPI

Marquis Dental Center PA

Doing business as Renew Dental

  • Customized Equipment (DME)
  • Tupelo, MS
National Provider Identifier
1508293531
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
1452-71 Issued in MS
Legal business name
MARQUIS DENTAL CENTER PA
Doing business as
Renew Dental
Practice address
1013 W Jackson St
Tupelo, MS 38804-1907
Phone
(662) 823-7900
Fax
(662) 823-7920
NPI assigned
Oct 4, 2013
Organization subpart
Yes
Parent organization
MARQUIS DENTAL CENTER PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Authorized official

Name
Dr. George Joseph Marquis, D.M.D.NPI 1982764122
Title
Owner
Phone
(662) 823-7900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 1452-71 MS Primary

Addresses

Primary practice location

1013 W Jackson St
Tupelo, MS 38804-1907

Mailing address

1013 W Jackson St
Tupelo, MS 38804-1907
Phone (662) 823-7900

Other names 1

  • Renew Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Marquis Dental Center PA

Locations

1203 N Gloster St
Ste M
Tupelo, MS 38804
Phone (662) 823-7900

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1508293531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 W JACKSON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041907",
            "telephone_number": "662-823-7900",
            "fax_number": "662-823-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 W JACKSON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388041907",
            "telephone_number": "662-823-7900",
            "fax_number": "662-823-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARQUIS DENTAL CENTER PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARQUIS DENTAL CENTER PA",
        "enumeration_date": "2013-10-04",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "MARQUIS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-823-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MS",
            "license": "1452-71",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.