Active NPI
Marina Michael, DDS
- Dentist
- Midland, TX
National Provider Identifier
1619326519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36024
- Practice address
- 4400 N Midland Dr Ste 702
Midland, TX 79707-3456 - Phone
- (432) 699-4811
- NPI assigned
- Jun 10, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D13684 | MN | |
| Dentist | 122300000X | 36024 | TX | Primary |
Addresses
Primary practice location
4400 N Midland Dr Ste 702
Midland, TX 79707-3456
Mailing address
4400 N Midland Dr Ste 702
Midland, TX 79707-3456
Phone (432) 699-4811
Other practice location 1
10904 Baltimore St NE Ste 100
Blaine, MN 55449-5062
Phone (612) 200-6881
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36024 | TX | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1619326519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 N MIDLAND DR STE 702",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797073456",
"telephone_number": "432-699-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 N MIDLAND DR STE 702",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797073456",
"telephone_number": "432-699-4811"
}
],
"practiceLocations": [
{
"address_1": "10904 Baltimore St NE Ste 100",
"address_purpose": "LOCATION",
"city": "Blaine",
"state": "MN",
"postal_code": "554495062",
"country_code": "US",
"telephone_number": "612-200-6881",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MICHAEL",
"first_name": "MARINA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-10",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13684",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "36024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
- MH Health Care Services, PC (Diamondback 5th Floor)
- MH Health Care Services, PC
- MH Health Care Services, PC
- MH Health Care Services, PC
- Michael Falk Crna PLLC
- Brian K Middlebrook, DPM
- Midessa Integrative Medicine
- Midkiff Road PC (The Kid's Place)
- Midland Academy Charter School
- Midland Ambulatory Surgery Center, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.