Mark Stivers, DDS, Inc., P.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MARK STIVERS, DDS, INC., P.S.

Practice address

12728 19TH Ave SE Ste 101
Everett, WA 98208-6526

Phone

(425) 224-4661

Fax

(425) 224-4689

NPI assigned

Dec 4, 2018

Organization subpart

No

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

Authorized official

Name

Mark W Stivers, DDSNPI 1316946437

Title

Owner

Phone

(425) 239-5600

Specialties & licenses 1

Addresses

Other names 1

• Silver Creek Oral Surgery and Puget Sound Oral Surgery Doing business as

Locations

Practitioners 1

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

• Mark W Stivers, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Everett, WA
  • NPI 1316946437
  NPD Authorized official

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1104396969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE STE 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-224-4661",
            "fax_number": "425-224-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE STE 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-224-4661",
            "fax_number": "425-224-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK STIVERS, DDS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "STIVERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-239-5600",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Creek Oral Surgery and Puget Sound Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Susan Marin, M.S., CCC-SLP
• Marqus Marinez
• Abigail Chelsea Mariott
• Maritime Expeditionary Security Squadron Nine
• Mark Osterberg DDS & Camille Murray DDS, PLLC
• Jessica Mark
• Sue Amy Mark, RPH
• Anurag Markanday, MD
• Allisha Anne Markham, CO61677137
• Cady Markin

• Oral and Maxillofacial Surgery (Dentist) in Everett, WA
• Providers in Everett, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.