David Randolph Marshall Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0442000392 Issued in VA

Practice address

616 Campus Dr Ste 100
Abingdon, VA 24210-9706

Phone

(276) 525-4487

NPI assigned

Jul 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Mission Dental Virginia, Inc

  • General Practice Dentistry
  • Abingdon, VA
  • NPI 1639785934
  NPD

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1568070829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13932 INDIANA ST APT 101",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242012230",
            "telephone_number": "434-284-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 CAMPUS DR STE 100",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242109706",
            "telephone_number": "276-525-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DAVID",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0442000392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Mangan, OT
• John Walter Mann III, M.D.
• Lena Manning, DO
• Brett Allen Manthey, D.O.
• Mark T Larsen LPC PC
• Tayla Grace Clark Martin
• Matthew Lamar Mason, BSW
• Renee P Mason, DPM
• Elizabeth Rose Mathisen, DPT
• Benjamin George Thomas Mavelil, DDS

• General Practice Dentistry in Abingdon, VA
• Providers in Abingdon, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.