Provider Demographics
NPI:1811253156
Name:MARION, IAN WILLIAM (DDS)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:WILLIAM
Last Name:MARION
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 1:801 S PAULINA ST # MC850
Mailing Address - Street 2:COLLEGE OF DENTISTRY ROOM 269-D
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7210
Mailing Address - Country:US
Mailing Address - Phone:312-413-9651
Mailing Address - Fax:
Practice Address - Street 1:2200 X ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2502
Practice Address - Country:US
Practice Address - Phone:916-245-0305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA644481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry