Individual provider Active NPI

Marriner Russell Morrell, DMD

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1861490526
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1058 Issued in AK
Practice address
625 E 34TH Ave Ste 200
Anchorage, AK 99503-4154
Phone
(907) 274-7691
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1058 AK Primary

Addresses

Primary practice location

625 E 34TH Ave Ste 200
Anchorage, AK 99503-4154

Mailing address

625 E 34TH Ave Ste 200
Anchorage, AK 99503-4154
Phone (907) 274-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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

Enrollment IDStateProvider typePAC IDDetails
I20190903001365 AK Order and Referring Only - DentistPractitioner - Dentist 8729393814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1058AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Denali Dental Care Past Accepting new patients
Robert E. Warren, DDS, Apc General Practice Past Accepting new patients
Marriner Russell Morrell, DMD, PC General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1861490526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E 34TH AVE STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034154",
            "telephone_number": "907-274-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 34TH AVE STE 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034154",
            "telephone_number": "907-274-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRELL",
        "first_name": "MARRINER",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.