Mark Edwin Flack, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12700 Issued in MO

Practice address

300 NW RR Mize Rd
Suite 100
Blue Springs, MO 64014-2528

Phone

(816) 229-3737

Fax

(816) 229-1656

NPI assigned

Jul 21, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 22, 2014 through Oct 22, 2026

Medicare enrollment (NPD)

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.

• Flack & Stone, D.D.S., P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Blue Springs, MO
  • NPI 1235171059
  NPD (past) Authorized official

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144241589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5457 NE WEDGEWOOD LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641223",
            "telephone_number": "816-373-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NW RR MIZE RD",
            "address_2": "SUITE 100",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142528",
            "telephone_number": "816-229-3737",
            "fax_number": "816-229-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "MARK",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "12700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Ferns
• Megan S Fields, DPT
• Susan Fields, PHARMD
• Thomas Allen Finley, DPT, PT
• Flack & Stone, D.D.S., P.C.
• Bailey Ryan Flathers
• Sheldon Fleishman, D.P.M.
• Kandice L. Fleming, M.D.
• Valerie Fombon, PHARM D
• Foot Specialists of Kansas City, P.a.

• Oral and Maxillofacial Surgery (Dentist) in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.