Montgomery W Marvel, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009250A Issued in IN

Practice address

829 Plaza Dr
Martinsville, IN 46151-3236

Phone

(765) 342-7090

Fax

(765) 342-6703

NPI assigned

Oct 3, 2006

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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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.

• Wells, Marvel & Hall, L.L.C.

  • General Practice Dentistry
  • Martinsville, IN
  • NPI 1841476876
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801980180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 PLAZA DR",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461513236",
            "telephone_number": "765-342-7090",
            "fax_number": "765-342-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 PLAZA DR",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461513236",
            "telephone_number": "765-342-7090",
            "fax_number": "765-342-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVEL",
        "first_name": "MONTGOMERY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009250A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN #",
            "identifier": "000000381014",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martinsville Family Eye Care Center Inc.
• Martinsville Fire Department
• Martinsville Pediatric Dentistry, L.L.C.
• Martinsville Pediatric Dentistry, LLC
• Martinsville Vision Clinic PC
• Taylor A McClone
• McFadden Family Dentistry, P.C.
• John Robert McFadden, DDS
• Samantha McMinn, LCSW
• Bryana McNeely

• General Practice Dentistry in Martinsville, IN
• Providers in Martinsville, IN by specialty
• General Practice Dentistry in Indiana

• 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.