Marc Huang Pan, D.M.D, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

059098 Issued in NY

Practice address

130 W Kingsbridge Rd
Bronx, NY 10468-3904

Phone

(718) 584-9000

NPI assigned

Apr 30, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1730406695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GARTH RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833750",
            "telephone_number": "646-580-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "718-584-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "MARC",
        "middle_name": "HUANG",
        "name_prefix": "Dr.",
        "credential": "D.M.D, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-30",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "059098",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomas Pamparas
• Shanta Kerina Pamphile, MA
• Michael Pamplona, PA
• Ethan Pan
• Jing-Yu Pan, M.D.
• Xinyue Pan, MD
• Yang Pan, OD
• Marjorie Borja Pana, P.T.
• Joanna Katherine Panagios-Kesar, LCSW
• Anna Vasiliki Panapakides

• Oral and Maxillofacial Surgery (Dentist) in Bronx, NY
• Providers in Bronx, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.