IVAN D MARKS (NPI# 1407857071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407857071 |
| Entity Type | Individual |
| Full Name | IVAN D MARKS |
| Credential | DMD |
| Practice Address |
3101 Breckenridge Ln Ste 2d Louisville KY 40220-2742 |
| Practice Telephone | 5024598012 |
| Practice Fax Number | 5024598021 |
| Mailing Telephone | 5024598012 |
| Mailing Fax Number | 5024598021 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2008-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3460 | KY | Dental Providers |
| N | 174400000X | Specialist | 3460 | KY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 60034600 | 05 | |
| KY | PASSPORT | 1055009 | 01 |
| KY | 64034606 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538346127 | Ivan Alan Marks | Dentist | 3801 Las Posas Rd, Suite 202, Camarillo, CA 93010-1427 | 2008-01-25 |
| Street Address |
3101 BRECKENRIDGE LN STE 2D |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40220-2742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053312066 | Richard A Pape | Dentist | 3101 Breckenridge Ln, Ste 2d, Louisville, KY 40220-2742 | 2005-08-02 |
| 1770728131 | Sonya C Worthington | Nurse Anesthetist, Certified Registered | 3101 Breckenridge Ln, Suite 1a, Louisville, KY 40220-2793 | 2008-12-12 |
| 1811170939 | Anthony Kelty | Nurse Anesthetist, Certified Registered | 3101 Breckenridge Ln, Suite 1a, Louisville, KY 40220-2742 | 2007-12-12 |
| 1790805562 | Mark A Blair | Dentist | 3101 Breckenridge Ln, 1-d, Louisville, KY 40220-2742 | 2007-03-29 |
| 1043336936 | Hershel Weinberg | Dentist | 3101 Breckenridge Ln, Suite 2a, Louisville, KY 40220-2742 | 2007-03-22 |
| 1841315207 | Paul E King, Dmd, Pllc | Clinic/Center | 3101 Breckenridge Ln, Suite 2a, Louisville, KY 40220-2742 | 2007-03-21 |
| 1598898413 | Jennifer Lynn Wright | Dentist | 3101 Breckenridge Ln, Suite 2a, Louisville, KY 40220-2742 | 2007-03-13 |
| 1265567572 | Louisville Internal Medicine & Pediatrics, LLC | Pediatrics | 3101 Breckenridge Ln, #4e, Louisville, KY 40220-2742 | 2007-02-23 |
| 1134288434 | Myron F Shuster, Dmd | Dentist | 3101 Breckenridge Ln, Suite 4b, Louisville, KY 40220-2742 | 2006-12-06 |
| 1679640114 | Myron F Shuster | Dentist | 3101 Breckenridge Ln, Suite 4b, Louisville, KY 40220-2742 | 2006-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502560 | Louis James Walker IIi | Physical Therapist | 8904 Elks Bluff Drive, Unit 02206, Apt 206, Louisville, KY 40220 | 2020-09-10 |
| 1396207148 | Kristan Shay Swindler | Specialist/Technologist, Other | 3008 Furman Blvd., Louisville, KY 40220 | 2019-04-02 |
| 1033686191 | Reine Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3405 Breckenridge Lane, Louisville, KY 40220 | 2018-10-26 |
| 1053828145 | Angelique Marie Leist | Registered Nurse | 3103 Breckenridge Ln Ste 1, Louisville, KY 40220 | 2018-01-10 |
| 1811413925 | Virginia Zimlich | Physical Therapist | 2807 Alice Ave, Louisville, KY 40220 | 2017-08-21 |
| 1255860649 | Susan Marie Elder | Registered Nurse | 2816 Esther Blvd, Louisville, KY 40220 | 2017-06-08 |
| 1215300611 | Katie Kipfer | Day Training/Habilitation Specialist | 3902 Graf Drive, Louisville, KY 40220 | 2015-11-06 |
| 1639547987 | Meghan Hillerich | Home Health | 13 Canterbury Drive, Louisville, KY 40220 | 2015-09-03 |
| 1376921098 | Dental Services of Kentucky, Psc | Dentist | 3946 Taylorsville Rd., Louisville, KY 40220 | 2015-05-14 |
| 1093103574 | Joann Bartolone Murphy | Developmental Therapist | 3717 Taylorsville Rd., Louisville, KY 40220 | 2015-01-06 |
| Find all providers in zip 40220 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
| 1922361062 | Alan Reisman, Dds, PC | Dentist | 1075 S Boulder Rd Ste 135, Louisville, CO 80027-2559 | 2012-06-22 |
| 1245481175 | Joseph H. Cieslak Dds, Pllc | Dentist | 6501 Dixie Hwy, Louisville, KY 40258-3907 | 2008-10-09 |
| 1033372057 | Lawrence Sivori II | Dentist | 3101 Breckenridge Ln Ste 2d, Louisville, KY 40220-2742 | 2008-07-09 |
| 1790944106 | David Naselsker | Dentist | 3421 Hycliffe Ave, Louisville, KY 40207-3659 | 2008-06-02 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1730382722 | Lewis C. Jones | Dentist | 401 E Chestnut St Unit 550, Louisville, KY 40202-5705 | 2007-06-07 |
| 1104982016 | Mark D. Miller | Dentist | 1211 W Broadway Unit 106, Louisville, KY 40203-2082 | 2006-12-28 |
| 1285709865 | David T Dodd | Dentist | 4122 Shelbyville Rd Ste 120, Louisville, KY 40207-3206 | 2006-11-21 |
| 1306933387 | Alan Jon Reisman | Dentist | 1075 E South Boulder Rd, Suite 230, Louisville, CO 80027-2560 | 2006-10-09 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40220 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.