Active NPI
William Jay Marley Jr., DDS
- Dentist
- Homer, AK
National Provider Identifier
1528154796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1023
- Practice address
- 4252 Hohe St
Ste a
Homer, AK 99603 - Phone
- (907) 235-8909
- Fax
- (907) 235-8517
- NPI assigned
- Oct 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1023 | AK | Primary |
Addresses
Primary practice location
4252 Hohe St
Ste a
Homer, AK 99603
Mailing address
143 E Bayview Ave
Homer, AK 99603
Phone (907) 235-9649
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD1413 | Medicaid | AK | |
| DE00009027 | Other | WA | WA STATE DEPT OF HEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1023 | AK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528154796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 E BAYVIEW AVE",
"city": "HOMER",
"state": "AK",
"postal_code": "99603",
"telephone_number": "907-235-9649",
"fax_number": "907-235-9649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4252 HOHE ST",
"address_2": "STE A",
"city": "HOMER",
"state": "AK",
"postal_code": "99603",
"telephone_number": "907-235-8909",
"fax_number": "907-235-8517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARLEY",
"first_name": "WILLIAM",
"middle_name": "JAY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1023",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DD1413",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA STATE DEPT OF HEALTH",
"identifier": "DE00009027",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Homer, AK
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.