Mark Herndon Whitefield

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7130 Issued in TN

Practice address

4251 Lebanon Pike
Hermitage, TN 37076-1206

Phone

(615) 889-5545

Fax

(615) 665-1066

NPI assigned

Mar 21, 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

Opted out of Medicare

Yes, effective Nov 17, 2015 through Nov 17, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Hermitage Cosmetic and Implant Dentistry Mark H Whitefield DDS Gen PTR

  • General Practice Dentistry
  • Hermitage, TN
  • NPI 1104410497
  NPD Authorized official
• WRH Serenity Dental General Partnership

  • General Practice Dentistry
  • Lebanon, TN
  • NPI 1821819558
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1295851558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 LEBANON PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761206",
            "telephone_number": "615-889-5545",
            "fax_number": "615-665-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 LEBANON PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761206",
            "telephone_number": "615-889-5545",
            "fax_number": "615-665-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEFIELD",
        "first_name": "MARK",
        "middle_name": "HERNDON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Alicia Wells, DVM
• Sarah Elizabeth Wells, AGACNP-BC
• Katherine Marie Welter, M.A., BCBA
• Thomas G Westermeier, MD
• Lowell Conrad Whitefield, DDS
• Candace A Whitley, PA-C
• Tara L Whitlock, ED.S.
• Kameela E Williams-Jackson, APN
• Amanda Williams, OT
• Cynthia Renee' Williams, NURSE PRACTITIONER

• General Practice Dentistry in Hermitage, TN
• Providers in Hermitage, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.