Individual provider Active NPI

Jose E Marquez, D.M.D.

  • General Practice Dentistry
  • Columbia, SC
National Provider Identifier
1568422525
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7107 Issued in SC
Practice address
3000 Two Notch Rd
Columbia, SC 29204-2822
Phone
(803) 691-9930
Fax
(803) 691-9322
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1862 PR
General Practice Dentistry 1223G0001X 7107 SC Primary

Addresses

Primary practice location

3000 Two Notch Rd
Columbia, SC 29204-2822

Mailing address

16 Arcade Unit 198747
Nashville, TN 37219-1994
Phone (615) 750-0343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618003289 SC Practitioner - Dentist 5496000325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1862PRMDDentist
7107SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc CurrentSince Jun 1, 2018 Accepting new patients
Two Notch Road Dental Health Center General Practice Past Accepting new patients
Columbia Smiles Youth Dentistry, LLC General Practice Past Accepting new patients

Locations

721 Okatie Hwy
Okatie, SC 29909

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EICIBD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1568422525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 TWO NOTCH RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042822",
            "telephone_number": "803-691-9930",
            "fax_number": "803-691-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "JOSE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1862",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "7107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.