Corry Lynn Marcincin, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

00201964 Issued in CO

Practice address

119 Main Street
Dillon, CO 80435

Phone

(970) 468-2471

NPI assigned

Apr 18, 2012

Sex

Female

Sole proprietor

Yes

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 CO

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 and National Provider Directory roles.

• Summit Dental, PLLC

  • Dental Clinic/Center
  • Dillon, CO
  • NPI 1649905761
  NPD (past)

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1902163702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4531",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "804354531",
            "telephone_number": "610-442-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MAIN STREET",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "80435",
            "telephone_number": "970-468-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINCIN",
        "first_name": "CORRY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00201964",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Dillon Eye Care, LLC
• Marissa J Lampe, LSW
• Auburn Larue
• Samuel Lipfield
• Melissa Hope Malter, LSW
• Lynsey Jenelle Maudlin, MASSAGE THERAPIST
• Mariah Mayerle
• McCoy Counseling LLC
• McCoy Counseling LLC
• Danielle Moulton

• All providers in Dillon, CO
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.