Individual provider Active NPI

Mark Craig Eissler, D.D.S.

  • General Practice Dentistry
  • Burleson, TX
National Provider Identifier
1013928076
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11713 Issued in TX
Practice address
916 Kingswood Dr
Burleson, TX 76028-4072
Phone
(817) 295-7591
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11713 TX Primary

Addresses

Primary practice location

916 Kingswood Dr
Burleson, TX 76028-4072

Mailing address

916 Kingswood Dr
Burleson, TX 76028-4072
Phone (817) 295-7591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 24, 2015 through Jul 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11713TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1013928076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 KINGSWOOD DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284072",
            "telephone_number": "817-295-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 KINGSWOOD DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284072",
            "telephone_number": "817-295-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISSLER",
        "first_name": "MARK",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "11713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.