Individual provider Active NPI

Patricia Claire Marshall, DDS

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1679466767
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15267 Issued in MN
Practice address
450 Syndicate St N Ste 300
Saint Paul, MN 55104-4127
Phone
(651) 254-7373
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 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 D15267 MN Primary

Addresses

Primary practice location

450 Syndicate St N Ste 300
Saint Paul, MN 55104-4127

Mailing address

215 Halsey Ave NE
Buffalo, MN 55313-8864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250616002744 MN Order and Referring Only - DentistPractitioner - Dentist 1355852443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D15267MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1679466767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HALSEY AVE NE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553138864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SYNDICATE ST N STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044127",
            "telephone_number": "651-254-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "PATRICIA",
        "middle_name": "CLAIRE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.