Active NPI
Marikit Tongo Magkalas, DMD
- General Practice Dentistry
- Killen, AL
National Provider Identifier
1861017279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D.0006759-C1
- Practice address
- 1367 US-72
Killen, AL 35645 - Phone
- (256) 272-3464
- NPI assigned
- Jun 11, 2020
- Last updated
- Oct 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN.00205774 | CO | |
| General Practice Dentistry | 1223G0001X | D.0006759-C1 | AL | Primary |
Addresses
Primary practice location
1367 US-72
Killen, AL 35645
Mailing address
5780 N Carefree Cir
Colorado Springs, CO 80917-2795
Phone (719) 300-4639
Other practice location 1
5780 N Carefree Cir
Colorado Springs, CO 80917-2795
Phone (719) 300-4639
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205774 | CO | MD | Dentist |
| D.0006759-C1 | AL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Singing River Dentistry Treehouse Killen, LLC | General Practice | Current | Accepting new patients |
Locations
1367 Highway 72
Killen, AL 35645
Phone (256) 272-3464
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Killen, AL
- NPI 1932854262
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1861017279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5780 N CAREFREE CIR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809172795",
"telephone_number": "719-300-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1367 US-72",
"city": "KILLEN",
"state": "AL",
"postal_code": "35645",
"telephone_number": "256-272-3464"
}
],
"practiceLocations": [
{
"address_1": "5780 N Carefree Cir",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809172795",
"country_code": "US",
"telephone_number": "719-300-4639",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAGKALAS",
"first_name": "MARIKIT",
"middle_name": "TONGO",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-11",
"last_updated": "2023-10-02",
"certification_date": "2023-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00205774",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "D.0006759-C1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killen, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.