Individual provider Active NPI

Lloyd H Marcum, D.D.S.

  • Endodontics
  • San Luis Obispo, CA
National Provider Identifier
1700127073
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
32357 Issued in CA
Practice address
1129 Pacific St
San Luis Obispo, CA 93401-3301
Phone
(805) 541-8731
Fax
(805) 541-8047
NPI assigned
Mar 11, 2013
Last updated
Mar 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 32357 CA Primary

Addresses

Primary practice location

1129 Pacific St
San Luis Obispo, CA 93401-3301

Mailing address

1129 Pacific St
San Luis Obispo, CA 93401-3301
Phone (805) 541-8731

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

LicenseStateTypeSpecialty
32357CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Lloyd Marcum DDS Inc Past Accepting new patients
Raymond Pandez DDS MSD Inc Endodontics PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1700127073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013301",
            "telephone_number": "805-541-8731",
            "fax_number": "805-541-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013301",
            "telephone_number": "805-541-8731",
            "fax_number": "805-541-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "LLOYD",
        "middle_name": "H",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-11",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "32357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.