Active NPI
Mark J Scribbins, DDS
- General Practice Dentistry
- Clear Lake, IA
National Provider Identifier
1245311190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6809
- Practice address
- 108 S 4TH St
Clear Lake, IA 50428-1940 - Phone
- (641) 357-3315
- Fax
- (641) 357-3376
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6809 | IA | Primary |
Addresses
Primary practice location
108 S 4TH St
Clear Lake, IA 50428-1940
Mailing address
108 S 4TH St
PO Box 65
Clear Lake, IA 50428-1940
Phone (641) 357-3315
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 271054657 | Other | IA | TTIN |
| 0193417 | Other | IA | PROVIDER ID |
| 6809 | Other | IA | LICENSE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6809 | IA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark J Scribbins | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Clear Lake, IA
- NPI 1396905295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1245311190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 S 4TH ST",
"address_2": "PO BOX 65",
"city": "CLEAR LAKE",
"state": "IA",
"postal_code": "504281940",
"telephone_number": "641-357-3315",
"fax_number": "641-357-3376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 S 4TH ST",
"city": "CLEAR LAKE",
"state": "IA",
"postal_code": "504281940",
"telephone_number": "641-357-3315",
"fax_number": "641-357-3376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCRIBBINS",
"first_name": "MARK",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "6809",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TTIN",
"identifier": "271054657",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER ID",
"identifier": "0193417",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "6809",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clear Lake, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.