Mark Douglas Madison, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6786 Issued in CO

Practice address

2525 N 8TH St
Suitte #109
Grand Junction, CO 81501-8845

Phone

(970) 256-9500

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013056159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 N 8TH ST",
            "address_2": "SUITTE #109",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018845",
            "telephone_number": "970-256-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 N 8TH ST",
            "address_2": "SUITTE #109",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018845",
            "telephone_number": "970-256-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Mackel, NP
• Sarah Jean Mackie
• Jodie Kim Mactavish
• Darilynn Sue Maddux, MEDICAL ASSISTANT
• Gilbert Isaac Madison, M.D.
• Susan Madison, PT
• Glenn M Madrid, MD
• Kelsi Madrid
• Mark C. Madsen, MD
• Justine April Maedeker, NP

• General Practice Dentistry in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.