Individual provider Active NPI

Marshall Hawkins, DDS

  • General Practice Dentistry
  • Alexandria, LA
National Provider Identifier
1942213533
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3832 Issued in LA
Practice address
1208 Wisteria St
Alexandria, LA 71301-6861
Phone
(318) 484-4801
NPI assigned
Aug 14, 2006
Last updated
Sep 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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 3832 LA Primary

Addresses

Primary practice location

1208 Wisteria St
Alexandria, LA 71301-6861

Mailing address

1208 Wisteria St
Alexandria, LA 71301-6861
Phone (318) 484-4801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20200221000730 LA Practitioner - Dentist 0446687909 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3832LAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Jan 6, 2020 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jan 6, 2020 Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

1208 Wisteria St
#4
Alexandria, LA 71301
Phone (318) 484-4801

71211 Highway 21
Ste B
Covington, LA 70433
Phone (985) 893-9922

1430 Tulane Ave
#8422
New Orleans, LA 70112
Phone (504) 422-3545

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, 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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1942213533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 WISTERIA ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713016861",
            "telephone_number": "318-484-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 WISTERIA ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713016861",
            "telephone_number": "318-484-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.