Active NPI
Paul Anthony Marino, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Boston, MA
National Provider Identifier
1861504920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 9402 MA
- Practice address
- One Kneeland St
Oral and Maxillofacial Surgery Dept
Boston, MA 02111 - Phone
- (617) 636-6515
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 9402 MA | MA | Primary |
Addresses
Primary practice location
One Kneeland St
Oral and Maxillofacial Surgery Dept
Boston, MA 02111
Mailing address
60 Indian Cove Way
South Easton, MA 02375
Phone (508) 238-5033
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 |
|---|---|---|---|
| 9402 MA | MA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861504920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 INDIAN COVE WAY",
"city": "SOUTH EASTON",
"state": "MA",
"postal_code": "02375",
"telephone_number": "508-238-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE KNEELAND ST",
"address_2": "ORAL AND MAXILLOFACIAL SURGERY DEPT",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "617-636-6515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "PAUL",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MA",
"license": "9402 MA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.