Chadwick J Marshall DMD MD PA Dba Gulf Coast Facial and Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CHADWICK J MARSHALL DMD MD PA DBA GULF COAST FACIAL AND ORAL SURGERY

Practice address

105 Hollywood Blvd NE
Fort Walton Beach, FL 32548-4922

Phone

(850) 269-7550

NPI assigned

Oct 25, 2023

Organization subpart

No

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

Authorized official

Name

Chadwick Marshall, DMD, MDNPI 1730283086

Title

Credentialing Specialist

Phone

(850) 269-7550

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chadwick J Marshall, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Walton Beach, FL
  • NPI 1730283086
  NPD Authorized official
• Lawerence S Horne, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Walton Beach, FL
  • NPI 1871560706
  NPD

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1730951435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HOLLYWOOD BLVD NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HOLLYWOOD BLVD NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484922",
            "telephone_number": "850-269-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHADWICK J MARSHALL DMD MD PA DBA GULF COAST FACIAL AND ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "CHADWICK",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "850-269-7550",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ketsarin Chaiyanut, MMP
• Karah Chandler Chambliss
• Edward William Chandler, PH.D.
• Sherry Chandler, APRN
• John Christopher Chaney, MD

• Oral and Maxillofacial Surgery (Dentist) in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.