Tina M Marshall, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

18092 Issued in MI

Practice address

1135 S Lapeer Rd
Lake Orion, MI 48360-1432

Phone

(248) 693-2194

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

Practice roles

Locations

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 M Marshall DDS PC

  • Dental Clinic/Center
  • Lake Orion, MI
  • NPI 1164040465
  NPD Authorized official
• James C Komendera DDS PC

  • General Practice Dentistry
  • Lake Orion, MI
  • NPI 1942377122
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1679787287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951S BALDWIN RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601665",
            "telephone_number": "248-391-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S LAPEER RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601432",
            "telephone_number": "248-693-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "18092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malgorzata Sobilo M D P C
• Matthew Mallmann, MOTR/L
• Racquel Malouf
• Suzana Marku, NP
• Gabriel Marrero
• Jessica Martin, MT
• Olha Marusyk
• Joseph Anthony Mastromatteo, D.D.S.
• Priya Ann Mathews, DDS
• Karma Maxwell, NP

• Dentist in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.