Provider Demographics
NPI:1467545087
Name:CUMMINGS, MARLOIN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARLOIN
Middle Name:C
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 GOLFSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7793
Mailing Address - Country:US
Mailing Address - Phone:904-737-8410
Mailing Address - Fax:
Practice Address - Street 1:9000 GOLFSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7793
Practice Address - Country:US
Practice Address - Phone:904-737-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1222061223P0221X
FLDN232341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ874330Medicaid