Mark James Scallon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS-09016 Issued in IA

Practice address

909 Lincoln Cir SE
Orange City, IA 51041-1861

Phone

(712) 737-4177

Fax

(712) 737-8718

NPI assigned

Jul 10, 2013

Last updated

Jul 10, 2013By the provider in NPPES

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

Enrolled in IA

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

Practice roles

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.

• Orange City Dentistry, Inc

  • General Practice Dentistry
  • Orange City, IA
  • NPI 1811066590
  NPD (past)

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1346681137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 LINCOLN CIR SE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411861",
            "telephone_number": "712-737-4177",
            "fax_number": "712-737-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 LINCOLN CIR SE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411861",
            "telephone_number": "712-737-4177",
            "fax_number": "712-737-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALLON",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Rivera
• Rock Chiropractic
• Kaileen Carol Roelofs, LMSW
• Tanya Rowenhorst, DPT
• Sanford Healthcare Accessories, LLC (Sanford Health Equip)
• Matthew Alan Schmidt, ATC
• Cassandra Grace Schmiesing
• Allison Hakes Schoenfelder, M.D.
• Kendra K Schroeder, ARNP
• Douglas L Schuller, PA-C

• General Practice Dentistry in Orange City, IA
• Providers in Orange City, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.