Individual provider Active NPI

Stephen H. Marshak, D.M.D.

  • General Practice Dentistry
  • Walpole, MA
National Provider Identifier
1912079716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10827 Issued in MA
Practice address
841 Main St
Suite 3
Walpole, MA 02081-2997
Phone
(508) 668-1531
Fax
(508) 668-0419
NPI assigned
Nov 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 10827 MA Primary

Addresses

Primary practice location

841 Main St
Suite 3
Walpole, MA 02081-2997

Mailing address

841 Main St
Suite 3
Walpole, MA 02081-2997
Phone (508) 668-1531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160216002363 MA Order and Referring Only - DentistPractitioner - Dentist 6901101740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
B. Saba D.M.D., P.C. General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912079716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MAIN ST",
            "address_2": "SUITE 3",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812997",
            "telephone_number": "508-668-1531",
            "fax_number": "508-668-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MAIN ST",
            "address_2": "SUITE 3",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812997",
            "telephone_number": "508-668-1531",
            "fax_number": "508-668-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHAK",
        "first_name": "STEPHEN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "10827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.