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Deactivated NPI 1487006649 Deactivated / Inactive NPI Male Practitioner

Erick Fernando Gomez Marroquin

Dentist • Boston, MA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Erick Gomez Marroquin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 11, 2016
NPI Deactivation Date October 22, 2021
Total Practice Duration ~5 Years of Practice (2016 – 2021)

Professional Overview & Biography Verified Profile Summary

Erick Gomez Marroquin was a registered Dentist practicing in Boston, MA. Throughout an active medical career spanning 5 years, Erick Gomez Marroquin provided care at the practice location at ONE KNEELAND ST until profile deactivation on 2021-10-22.

Practice Location & Contact Primary Location

Practice Address

One Kneeland St
Room 416

Boston, MA 02111

Telephone 6176366814

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Boston, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.9 Yrs
State Avg: 18.4 Yrs
Regional Practice Density
750 Specialists

Practicing in Boston, MA (3030 Statewide)

Telehealth Adoption Rate
0.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-10-28
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MA DF11888

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License MA DF11773

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - Orofacial Pain

NUCC Taxonomy Code: 1223X2210X

State License FL DN23854

A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1093213670

Doctor of Dental Medicine

NPI 1558983551

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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Updated Practice Location December 08, 2021

Registered at ONE KNEELAND ST, ROOM 416, BOSTON, MA 02111 (Tel: 6176366814)

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Updated Business Mailing Address December 08, 2021

Registered at 34 CAMBRIDGE STREET, APARTMENT 2211, CHARLESTOWN, MA 02129 (Tel: 8605159228)

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Provider Name / Credentials Updated December 08, 2021

Recorded as ERICK GOMEZ MARROQUIN

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 08, 2021

Dentist (License #DF11773 in MA)

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NPI Profile Deactivated October 22, 2021

Record deactivated on October 22, 2021

NPI Profile Active July 13, 2016

NPI status registered as active in NPPES database

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Updated Practice Location July 13, 2016

Registered at 263 FARMINGTON AVE, FARMINGTON, CT 060300001 (Tel: 8606792000)

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Updated Business Mailing Address July 13, 2016

Registered at 357 BRITTANY FARMS RD APT 22, NEW BRITAIN, CT 060531103 (Tel: 8605159228)

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Provider Name / Credentials Updated July 13, 2016

Recorded as ERICK GOMEZ MARROQUIN

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2016

Student in an Organized Health Care Education/Training Program

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Initial NPI Registration & Enumeration July 11, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487006649
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 11, 2016
Last Update: October 28, 2022
Deactivation Date: October 22, 2021
Sole Proprietor: No

Mailing Address

34 Cambridge Street, Apartment 2211

Charlestown, MA 02129

Phone: 8605159228

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.