Individual provider Active NPI

Marvis Yvonne Sorrell, D.M.D., M.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Long Beach, CA
National Provider Identifier
1578621801
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
031711 Issued in CA
Practice address
1777 N Bellflower Blvd
#202
Long Beach, CA 90815-4020
Phone
(562) 597-3639
Fax
(562) 597-6236
NPI assigned
Dec 6, 2006
Last updated
Jun 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 031711 CA Primary

Addresses

Primary practice location

1777 N Bellflower Blvd
#202
Long Beach, CA 90815-4020

Mailing address

1777 N Bellflower Blvd
#202
Long Beach, CA 90815-4020
Phone (562) 597-3639

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
031711CAMDOrthodontics and Dentofacial Orthopedic Dentist

Interoperability endpoints

  • Direct secure messaging: msorrell@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1578621801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD",
            "address_2": "#202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154020",
            "telephone_number": "562-597-3639",
            "fax_number": "562-597-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD",
            "address_2": "#202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154020",
            "telephone_number": "562-597-3639",
            "fax_number": "562-597-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRELL",
        "first_name": "MARVIS",
        "middle_name": "YVONNE",
        "credential": "D.M.D., M.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "031711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.