Organization Active NPI

Mark J Scribbins

  • General Practice Dentistry
  • Clear Lake, IA
National Provider Identifier
1396905295
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6809 Issued in IA
Legal business name
MARK J SCRIBBINS
Practice address
108 S 4TH St
Clear Lake, IA 50428-1940
Phone
(641) 357-3315
Fax
(641) 357-3376
NPI assigned
Jun 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Mark J Scribbins, D.D.SNPI 1245311190
Title
Dentist-Owner
Phone
(641) 357-3315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6809 IA Primary

Addresses

Primary practice location

108 S 4TH St
Clear Lake, IA 50428-1940

Mailing address

108 S 4TH St
PO Box 65
Clear Lake, IA 50428-1940
Phone (641) 357-3315

Other identifiers 2

IdentifierTypeStateIssuer
LICENSE NUMBEROtherIA6809
PROVIDER IDOtherIA0193417

National Provider Directory

National Provider Directory

Locations

108 S 4th St
Clear Lake, IA 50428
Phone (641) 357-3315

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1396905295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S 4TH ST",
            "address_2": "PO BOX 65",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281940",
            "telephone_number": "641-357-3315",
            "fax_number": "641-357-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S 4TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281940",
            "telephone_number": "641-357-3315",
            "fax_number": "641-357-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J SCRIBBINS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SCRIBBINS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST-OWNER",
        "authorized_official_telephone_number": "641-357-3315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "6809",
            "identifier": "LICENSE NUMBER",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0193417",
            "identifier": "PROVIDER ID",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clear Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.