Provider Demographics
NPI:1609957257
Name:STROHSCHEIN, MARVIN JAMES JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:JAMES
Last Name:STROHSCHEIN
Suffix:JR
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 1:609 TULANE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1346
Mailing Address - Country:US
Mailing Address - Phone:503-926-4548
Mailing Address - Fax:
Practice Address - Street 1:110 SHEEPS SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:JEMEZ PUEBLO
Practice Address - State:NM
Practice Address - Zip Code:87024-6548
Practice Address - Country:US
Practice Address - Phone:575-834-7413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD2007122300000X
ORD9325122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR5317Medicaid