Dr. Mark Pothitakis

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7584 Issued in IA

Legal business name

DR. MARK POTHITAKIS

Practice address

107 E Toothache Dr
New London, IA 52645-1141

Phone

(319) 367-2311

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark Christ Pothitakis, D.D.S.NPI 1780799189

Title

Owner

Phone

(319) 367-2311

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Christ Pothitakis, D.D.S.

  • General Practice Dentistry
  • New London, IA
  • NPI 1780799189
  NPD (past) Authorized official

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1073770467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E TOOTHACHE DR",
            "city": "NEW LONDON",
            "state": "IA",
            "postal_code": "526451141",
            "telephone_number": "319-367-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E TOOTHACHE DR",
            "city": "NEW LONDON",
            "state": "IA",
            "postal_code": "526451141",
            "telephone_number": "319-367-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK POTHITAKIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "POTHITAKIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CHRIST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-367-2311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0086785",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER MILITARY",
            "identifier": "831-776",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Care Initiatives (New London Specialty Care)
• Benjamin Ryan Carter, D.C.
• Erin Mollie Garvey, PTA
• Sylvia Ann Graber, ARNP
• Henry County Health Center, Inc. (Henry County Health Center - New London Clinic)
• Henry County Soldiers' and Sailors' Memorial Hospital (Physicians & Clinics of HCHC - New London)
• Grant McPheron, O.D.

• General Practice Dentistry in New London, IA
• Providers in New London, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.