Individual provider Active NPI

Beth Morgan Marks, D.D.S.

  • Dentist
  • Fort Wayne, IN
National Provider Identifier
1609186444
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12009534 Issued in IN
Practice address
6221 Covington Rd
Fort Wayne, IN 46804-7311
Phone
(260) 432-4329
Fax
(260) 434-1570
NPI assigned
Oct 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12009534 IN Primary

Addresses

Primary practice location

6221 Covington Rd
Fort Wayne, IN 46804-7311

Mailing address

6221 Covington Rd
Fort Wayne, IN 46804-7311
Phone (260) 432-4329

Other practice location 1

1121 W Michigan St
Indianapolis, IN 46202-5211
Phone (317) 274-7433

Other practice location 2

2101 E. Coliseum Blvd
Neff Hall 109
Fort Wayne, IN 46805-1499
Phone (260) 481-4839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20260320003588 IN Order and Referring Only - DentistPractitioner - Dentist 0840774410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009534INMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1609186444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 COVINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047311",
            "telephone_number": "260-432-4329",
            "fax_number": "260-434-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 COVINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047311",
            "telephone_number": "260-432-4329",
            "fax_number": "260-434-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 E. Coliseum Blvd",
            "address_2": "Neff Hall 109",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468051499",
            "country_code": "US",
            "telephone_number": "260-481-4839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "BETH",
        "middle_name": "MORGAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.