Mark Michna, DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39586 Issued in CA

Legal business name

MARK MICHNA, DDS, INC.

Practice address

599 Sir Francis Drake Blvd
Suite 306
Greenbrae, CA 94904-1712

Phone

(415) 461-5351

Fax

(415) 461-4614

NPI assigned

Apr 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mark Michna, DDSNPI 1417143082

Title

Dentist

Phone

(415) 461-4614

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mark Andrew Michna, D.D.S.

  • General Practice Dentistry
  • Greenbrae, CA
  • NPI 1417143082
  NPD (past) Authorized official

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1174814008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE 306",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041712",
            "telephone_number": "415-461-5351",
            "fax_number": "415-461-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE 306",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041712",
            "telephone_number": "415-461-5351",
            "fax_number": "415-461-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK MICHNA, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "MICHNA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "415-461-4614",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.