Gracen McGuckin Marriott, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

38839 Issued in TX

Practice address

11200 Menchaca Rd Ste 1
Austin, TX 78748-2747

Phone

(512) 646-4500

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Gracen Marie McGuckin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tina'S Tiny Texans

  • Pediatric Dentistry
  • Austin, TX
  • NPI 1235508789
  NPD (past)

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1629649009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7838 HUEBNER RD APT 4107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782406126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 MENCHACA RD STE 1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482747",
            "telephone_number": "512-646-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8210 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293923",
            "country_code": "US",
            "telephone_number": "210-450-3504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARRIOTT",
        "first_name": "GRACEN",
        "middle_name": "MCGUCKIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACEN",
            "last_name": "MCGUCKIN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Marquez, OTR
• Yanin Itzel Marquez
• Jared Dieudonne Marquis, CAA
• Robert Edward Marquis, M.D., PH.D.
• Gina Reve Marriott, LPC, LSSP
• Melissa Marriott, RD, LD
• Suzette Marriott, LCSW, CGP
• James Crawford Marroquin, MD
• Robbin Bubb Marroquin, M.D.
• Dustin Q Marruffo, RN, WCN-C, CSWD-C

• Dentist in Austin, TX
• Providers in Austin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.