DR. MARCUS BRIAN TANABE DDS NPI 1336368240

NPI Information

  • NPI: 1336368240
  • Provider Name: DR. MARCUS BRIAN TANABE, DDS
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1165 S COLUMBIA RD STE C
    GRAND FORKS, ND
    ZIP 58201
  • Phone: (701) 772-7379

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NPI Details

DR. Marcus Brian Tanabe, DDS is an oral and maxillofacial surgery dentist in Grand Forks, ND with 23 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in 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. DR. Marcus Brian Tanabe, DDS NPI is 1336368240. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MINNESOTA, DULUTH SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

1165 S COLUMBIA RD STE C
GRAND FORKS, ND
ZIP 58201-007
Phone: (701) 772-7379
Fax: (701) 772-9643

The NPI 1336368240 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)

The enumeration date for this NPI number is 4/25/2007 and was last updated on 10/31/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery1950NORTH DAKOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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