Mark Komforti, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30.025704 Issued in OH

Practice address

16909 Chagrin Blvd
Shaker Heights, OH 44120-3725

Phone

(216) 862-0544

NPI assigned

Aug 23, 2010

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Happy Smiles Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • St Augustine, FL
  • NPI 1922847078
  NPD Authorized official

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1093021578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16909 CHAGRIN BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441203725",
            "telephone_number": "216-862-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 CHAGRIN BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441203725",
            "telephone_number": "216-862-0544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 REILLY ROAD",
            "address_2": "USA DENTAL ACTIVITY STOP B",
            "address_purpose": "LOCATION",
            "city": "Fort BRAGG",
            "state": "NC",
            "postal_code": "283107302",
            "country_code": "US",
            "telephone_number": "910-643-2196",
            "fax_number": "910-396-7017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMFORTI",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-23",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30.025704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Koch, M.D.
• Jessica L Koch, LPC
• Abigail Koerwitz
• Sarah Kohlmorgan
• Alla Kolkin, M.D02
• Yaroslav Kondouch
• Danelle Erin Koppes, NP
• Gretchen Emily Kreider, M.S., CCC-SLP
• Heather Krijt
• Daniel Steven Kristoff, PT, DPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Shaker Heights, OH
• Providers in Shaker Heights, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.