Mark E Raider, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50 052961 Issued in NY

Practice address

888 Route 6
Mahopac, NY 10541-6201

Phone

(845) 628-3700

Fax

(845) 628-3010

NPI assigned

Apr 19, 2007

Last updated

Jan 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

• Acosta and Raider LLC

  • Dentist
  • Mahopac, NY
  • NPI 1528364551
  Authorized official Same address or phone

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1285851220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 ROUTE 6",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105416201",
            "telephone_number": "845-628-3700",
            "fax_number": "845-628-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 ROUTE 6",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105416201",
            "telephone_number": "845-628-3700",
            "fax_number": "845-628-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIDER",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50 052961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Mahopac, NY
• Providers in Mahopac, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.