Individual provider Active NPI

Mark Joseph Weber, D.M.D.

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1356493241
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5062 Issued in KY
Practice address
9513 Whipps Mill Rd
Louisville, KY 40242-3640
Phone
(502) 426-1481
Fax
(502) 423-8553
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5062 KY Primary

Addresses

Primary practice location

9513 Whipps Mill Rd
Louisville, KY 40242-3640

Mailing address

9513 Whipps Mill Rd
Louisville, KY 40242-3640
Phone (502) 426-1481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20140307000558 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648400861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356493241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 WHIPPS MILL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402423640",
            "telephone_number": "502-426-1481",
            "fax_number": "502-423-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 WHIPPS MILL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402423640",
            "telephone_number": "502-426-1481",
            "fax_number": "502-423-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "5062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.