Active NPI
Aksana Marshall, D.M.D, M.S.
- Pediatric Dentistry
- Tifton, GA
National Provider Identifier
1942636535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN014087
- Practice address
- 820 Love Ave Ste a
Tifton, GA 31794-4000 - Phone
- (706) 288-9582
- NPI assigned
- Sep 16, 2013
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN014087 | GA | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN014087 | GA |
Addresses
Primary practice location
820 Love Ave Ste a
Tifton, GA 31794-4000
Mailing address
1249 Bryan St W
Douglas, GA 31533-2001
Phone (706) 288-9582
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN014087 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1942636535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1249 BRYAN ST W",
"city": "DOUGLAS",
"state": "GA",
"postal_code": "315332001",
"telephone_number": "706-288-9582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 LOVE AVE STE A",
"city": "TIFTON",
"state": "GA",
"postal_code": "317944000",
"telephone_number": "706-288-9582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "AKSANA",
"name_prefix": "Dr.",
"credential": "D.M.D, M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-16",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN014087",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "GA",
"license": "DN014087",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.