Jerome Mark Falkoff, DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

2640 Issued in AR

Practice address

912 N Jackson
Magnolia, AR 71753-2446

Phone

(870) 234-0450

Fax

(870) 234-5662

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• J Mark Falkoff DDS PA

  • Dentist
  • Magnolia, AR
  • NPI 1396949343
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639289788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N JACKSON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532446",
            "telephone_number": "870-234-0450",
            "fax_number": "870-234-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 N JACKSON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532446",
            "telephone_number": "870-234-0450",
            "fax_number": "870-234-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALKOFF",
        "first_name": "JEROME",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "2640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "58827",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "849579",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmalee Beene-Gregory DDS
• Martin L Engeran, MS
• Eddie Scott Epperson, O.D
• Erica Danielle Erwin
• Faith and Family Medical Providers PLLC
• Ahna Farrar
• Terry Wayne Feyen, PD
• Melissa G Fields
• Christian Brooke Finney, COTA/L
• Rollie W Flaherty, PHD

• Dentist in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.