Individual provider Active NPI

Steven K Mark, D.M.D.

  • General Practice Dentistry
  • Lumberton, NC
National Provider Identifier
1023340551
Registry record updated Mar 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13513 Issued in NC
Practice address
600 Country Club Rd
Lumberton, NC 28360-0428
Phone
(910) 737-6457
NPI assigned
Feb 9, 2010
Last updated
Mar 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 047861-1 NY
General Practice Dentistry 1223G0001X 047861-1 NY
General Practice Dentistry 1223G0001X 13513 NC Primary

Addresses

Primary practice location

600 Country Club Rd
Lumberton, NC 28360-0428

Mailing address

600 Country Club Rd
Lumberton, NC 28360-0428
Phone (910) 737-6457

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
I20240320004064 NC Practitioner - Dentist 6709223191 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047861-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Feb 15, 2024 Accepting new patients
East Carolina University Dentist CurrentSince Jul 28, 2024 Accepting new patients
East Carolina University Dentist CurrentSince Feb 15, 2024 Accepting new patients
East Carolina University Current Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

600 Country Club Rd
Lumberton, NC 28360
Phone (910) 737-6457

Organizations & group practices 4

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709424000000",
    "number": "1023340551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COUNTRY CLUB RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283600428",
            "telephone_number": "910-737-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COUNTRY CLUB RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283600428",
            "telephone_number": "910-737-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "STEVEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047861-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047861-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.