Mark W Stivers, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS9908 Issued in TN

Practice address

12728 19TH Ave SE # 101
Everett, WA 98208

Phone

(425) 224-4661

NPI assigned

Jul 20, 2005

Last updated

Jul 25, 2018By 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

Enrolled in WA

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.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Washington

  dba University of Washington Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Medicare reassignment NPD
• Mark Stivers, DDS, Inc., P.S.

  dba Silver Creek Oral Surgery and Puget Sound Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Everett, WA
  • NPI 1104396969
  NPD Authorized official
• University of Washington

  dba University of Washington Medical Center Ambulatory

  • Community/Retail Pharmacy
  • Seattle, WA
  • NPI 1013950336
  NPD
• University of Washington

  dba UW Dentists - Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
  • NPI 1205999570
  NPD

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1316946437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE # 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-224-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE # 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-224-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVERS",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS9908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Stickler-Ivie, PA
• Deborah D. Stiles, A.R.N.P.
• Emily Stiles
• Kirsten Stinardo
• Erika Michelle Stinchcomb, ATC
• Erin Marie Stjern
• Laurie Lynne Stock, BSN
• Erin Stockhausen, LMHC, CN
• Mark Clifford Stockwell, D.D.S.
• Ellen M. Stoecker, ARNP

• Oral and Maxillofacial Surgery (Dentist) in Everett, WA
• Providers in Everett, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.