Mark D Zajkowski, DDS,MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3563 Issued in ME

Practice address

20 Long Creek Dr
Suite B
South Portland, ME 04106-2425

Phone

(207) 772-4063

Fax

(207) 772-8641

NPI assigned

Oct 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2013 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Oral & Maxillofacial Surgery Associates PA

  • Oral and Maxillofacial Surgery (Dentist)
  • South Portland, ME
  • NPI 1780765495
  NPD (past) Authorized official

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1366432189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LONG CREEK DR",
            "address_2": "SUITE B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062425",
            "telephone_number": "207-772-4063",
            "fax_number": "207-772-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LONG CREEK DR",
            "address_2": "SUITE B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062425",
            "telephone_number": "207-772-4063",
            "fax_number": "207-772-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJKOWSKI",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "DDS,MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "3563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316710099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Margaret Yerardi, PT, DPT
• Youth Alternatives Ingraham
• Margaret J. Zamboni, DO
• Weiland Zhang
• Zion Care LLC
• Brittany H Zobell, PA-C
• Jennifer Zorn, LADC ,LSW

• Oral and Maxillofacial Surgery (Dentist) in South Portland, ME
• Providers in South Portland, ME by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.