Individual provider Active NPI

Mark Jay Katz, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Greensboro, NC
National Provider Identifier
1013008218
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
4915 Issued in NC
Practice address
2018 New Garden Rd Ste a
Greensboro, NC 27410-2486
Phone
(336) 286-5800
Fax
(336) 286-5801
NPI assigned
Sep 27, 2006
Last updated
Aug 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4915 NC
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 4915 NC Primary

Addresses

Primary practice location

2018 New Garden Rd Ste a
Greensboro, NC 27410-2486

Mailing address

2018 New Garden Rd Ste a
Greensboro, NC 27410-2486
Phone (336) 286-5800

Other identifiers 1

IdentifierTypeStateIssuer
8994777MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111003000008 NC Practitioner - Oral SurgeryPractitioner - Other (Physician) 9931371689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4915NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J Katz, DDS, MSD, PA Orthodontics and Dentofacial Orthopedics CurrentSince Aug 17, 2011 Accepting new patients
NC Sleep Solutions, LLC PastSince Aug 17, 2011 Accepting new patients

Locations

2018 New Garden Rd
Ste A
Greensboro, NC 27410
Phone (336) 286-5800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1013008218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 NEW GARDEN RD STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102486",
            "telephone_number": "336-286-5800",
            "fax_number": "336-286-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 NEW GARDEN RD STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102486",
            "telephone_number": "336-286-5800",
            "fax_number": "336-286-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "MARK",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "4915",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "4915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8994777",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.