Thomas Elliott Marshall II, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014641 Issued in GA

Practice address

378 Savannah Ave
Statesboro, GA 30458-5163

Phone

(912) 764-4403

NPI assigned

Jul 19, 2013

Last updated

Jul 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason R. McGibony, DMD PC

  • General Practice Dentistry
  • Statesboro, GA
  • NPI 1265659437
  NPD (past)

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1932541935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FAIRWAY DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589110",
            "telephone_number": "912-690-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585163",
            "telephone_number": "912-764-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "THOMAS",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark S McCracken MD PC
• Marian J Marrero, PA-C
• Amber Johnson Marsh
• Megan Elizabeth Marsh, FNP-BC
• Lexi Marshall, CRNA
• Alyssa Martin, AGACNP-BC
• John Edward Martin Sr., MD
• Stephen R. Martin, DO, MPA, MSHSA
• Vincent Lee Martin, CHIROPRACTOR
• Kathryn Winn Marucco, PNP

• General Practice Dentistry in Statesboro, GA
• Providers in Statesboro, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.