William Walter Marshall II, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2002023192 Issued in MO

Practice address

1609 Maffry Ave
Macon, MO 63552-1960

Phone

(660) 385-3413

Fax

(660) 385-7069

NPI assigned

Apr 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MO

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

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.

• Long Branch Dental Group, del G. Gregory, D.D.S., PC

  • General Practice Dentistry
  • Macon, MO
  • NPI 1043433451
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750504148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 KARAT PLACE",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635524144",
            "telephone_number": "660-385-3413",
            "fax_number": "660-385-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 MAFFRY AVE",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521960",
            "telephone_number": "660-385-3413",
            "fax_number": "660-385-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "WILLIAM",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2002023192",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macon County Sheltered Workshop (Macon Diversified Industries)
• Macon Rehabilitation Services, LLC
• Mark Vincent Maddox, O.D.
• Donet Christopher Main, DO
• Jessica March, MSN, FNP-BC
• Matthew Theriac, D.D.S. LLC
• Lisa Michelle Mayes, D.O.
• Shaylyn McCollough, PHARMD
• James W McDowell, MD
• McPherson Medical & Diagnostic LLC (American Medical Missouri)

• General Practice Dentistry in Macon, MO
• Providers in Macon, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.