Mark Axelrode, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

40528 Issued in CA

Practice address

2000 Appian Way
Suite 301
Pinole, CA 94564-2574

Phone

(510) 724-8855

Fax

(510) 724-8861

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not 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.

• Axelrode Professional Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pinole, CA
  • NPI 1154167229
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215055819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 APPIAN WAY",
            "address_2": "SUITE 301",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642574",
            "telephone_number": "510-724-8855",
            "fax_number": "510-724-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 APPIAN WAY",
            "address_2": "SUITE 301",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642574",
            "telephone_number": "510-724-8855",
            "fax_number": "510-724-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELRODE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "40528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Arana
• Connor Leon Archer, D.C.
• Kay Arciaga
• Caleb Abeku Arthur, MD
• Axelrode Professional Corporation
• Azadeh Hosseini DDS Inc
• Behnoosh Bahrami
• Paula Baluyot
• Gina Banks, OTR/L
• Marcia Anne Banks, M.A.

• Orthodontics and Dentofacial Orthopedics Dentistry in Pinole, CA
• Providers in Pinole, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• 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.