Individual provider Active NPI

Mark H. Webb, D.D.S.

  • General Practice Dentistry
  • Bristol, TN
National Provider Identifier
1164438362
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-3188 Issued in TN
Practice address
523 Holston Ave
Suite 3
Bristol, TN 37620-2131
Phone
(423) 968-5112
Fax
(423) 968-5687
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-3188 TN Primary

Addresses

Primary practice location

523 Holston Ave
Suite 3
Bristol, TN 37620-2131

Mailing address

523 Holston Ave
Suite 3
Bristol, TN 37620-2131
Phone (423) 968-5112

Other identifiers 1

IdentifierTypeStateIssuer
7813929MedicaidVA

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

LicenseStateTypeSpecialty
DS-3188TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Webb Dentistry PLLC General Practice PastSince Feb 14, 2021 Accepting new patients
Webb Dentistry 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164438362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 HOLSTON AVE",
            "address_2": "SUITE 3",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376202131",
            "telephone_number": "423-968-5112",
            "fax_number": "423-968-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 HOLSTON AVE",
            "address_2": "SUITE 3",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376202131",
            "telephone_number": "423-968-5112",
            "fax_number": "423-968-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "MARK",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS-3188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7813929",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.