Individual provider Active NPI

Mark L Marz, DDS

  • Dentist
  • Iowa City, IA
National Provider Identifier
1184772238
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6351 Issued in IA
Practice address
322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone
(319) 335-7440
Fax
(319) 333-7451
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6351 IA Primary

Addresses

Primary practice location

322 Dental Science BLDG S
Iowa City, IA 52242-1001

Mailing address

322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone (319) 335-7440

Other practice location 1

4304 220th Trl
Amana, IA 52203-8025
Phone (319) 622-3150

Other identifiers 1

IdentifierTypeStateIssuer
0156083OtherIADELTA DENTAL OF IOWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803002390 IA Practitioner - Oral Surgery 2769666858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06351IAMDClinical Social Worker
6351IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa Dentist CurrentSince Jul 1, 2020 Accepting new patients
State University of Iowa CurrentSince Jul 1, 2020 Accepting new patients

Locations

322 Dental Science S
Iowa City, IA 52242
Phone (319) 335-7342

322 Dental Science S
Bldg S
Iowa City, IA 52242
Phone (319) 384-1139

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1184772238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DENTAL SCIENCE BLDG S",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-333-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 DENTAL SCIENCE BLDG S",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-333-7451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4304 220th Trl",
            "address_purpose": "LOCATION",
            "city": "Amana",
            "state": "IA",
            "postal_code": "522038025",
            "country_code": "US",
            "telephone_number": "319-622-3150",
            "fax_number": "319-622-3061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARZ",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "6351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF IOWA",
            "identifier": "0156083",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.