Active NPI
Mark A Penshorn, DDS
- Dentist
- Schertz, TX
National Provider Identifier
1417394396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13376
- Practice address
- 2501 FM 3009
Schertz, TX 78154-2714 - Phone
- (210) 659-1379
- Fax
- (210) 659-6215
- NPI assigned
- May 31, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13376 | TX | Primary |
Addresses
Primary practice location
2501 FM 3009
Schertz, TX 78154-2714
Mailing address
2501 FM 3009
Schertz, TX 78154-2714
Phone (210) 659-1379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13376 | TX | MD | Dentist |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Schertz, TX
- NPI 1518134477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1417394396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 FM 3009",
"city": "SCHERTZ",
"state": "TX",
"postal_code": "781542714",
"telephone_number": "210-659-1379",
"fax_number": "210-659-6215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 FM 3009",
"city": "SCHERTZ",
"state": "TX",
"postal_code": "781542714",
"telephone_number": "210-659-1379",
"fax_number": "210-659-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENSHORN",
"first_name": "MARK",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-31",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "13376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schertz, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.