Individual provider Active NPI

Mark I Degen, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
National Provider Identifier
1215002225
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
10535 Issued in NV
Practice address
6140 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-6737
Phone
(702) 253-9090
Fax
(702) 253-9083
NPI assigned
Nov 22, 2006
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 10535 NV Primary

Addresses

Primary practice location

6140 S Fort Apache Rd Ste 120
Las Vegas, NV 89148-6737

Mailing address

4730 S Fort Apache Rd
Ste 390
Las Vegas, NV 89147-7945
Phone (702) 253-9090

Other identifiers 2

IdentifierTypeStateIssuer
1598946261OtherNVGROUP NPI NUMBER
200078388OtherNVTAX ID

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 3, 2015 through Apr 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mark I Degen DDS MD LTD Oral and Maxillofacial Surgery Current Accepting new patients

Locations

4730 S Fort Apache Rd
Ste 390
Las Vegas, NV 89147
Phone (702) 253-9090

6140 S Fort Apache Rd
Ste 120
Las Vegas, NV 89148
Phone (702) 253-9090

Interoperability endpoints

  • Direct secure messaging: mdegen13166@direct.umcsn.com

Organizations & group practices 1

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1215002225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 S FORT APACHE RD",
            "address_2": "STE 390",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477945",
            "telephone_number": "702-253-9090",
            "fax_number": "702-253-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S FORT APACHE RD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891486737",
            "telephone_number": "702-253-9090",
            "fax_number": "702-253-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEN",
        "first_name": "MARK",
        "middle_name": "I",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "10535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1598946261",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "200078388",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.