Active NPI
Mark D. Valrose, D.M.D.
- Dentist
- Athens, OH
National Provider Identifier
1053737445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.025353
- Practice address
- 80 Columbus Rd
Athens, OH 45701-1312 - Phone
- (847) 594-6000
- NPI assigned
- Mar 10, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.025353 | OH | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | GA |
Addresses
Primary practice location
80 Columbus Rd
Athens, OH 45701-1312
Mailing address
20823 W Chartwell Dr
Kildeer, IL 60047-8582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.025353 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dental Health Group LLC | Past | Accepting new patients | |
| Flat Rock Family Dentistry, P.a. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba Family Dental Health of Flatrock
- General Practice Dentistry
- Greenville, SC
- NPI 1811721061
-
- General Practice Dentistry
- Greenville, SC
- NPI 1114101557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1053737445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20823 W CHARTWELL DR",
"city": "KILDEER",
"state": "IL",
"postal_code": "600478582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 COLUMBUS RD",
"city": "ATHENS",
"state": "OH",
"postal_code": "457011312",
"telephone_number": "847-594-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALROSE",
"first_name": "MARK",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-10",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.025353",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "GA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.