Mark W An, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00010456 Issued in WA

Practice address

11811 Mukilteo Speedway
Suite 102
Mukilteo, WA 98275-5442

Phone

(425) 267-9900

Fax

(425) 267-9901

NPI assigned

Jan 13, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark an DDS, PS

  • Dental Clinic/Center
  • Mukilteo, WA
  • NPI 1841839396
  NPD (past) Authorized official

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437200854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 MUKILTEO SPEEDWAY",
            "address_2": "SUITE 102",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755442",
            "telephone_number": "425-267-9900",
            "fax_number": "425-267-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 MUKILTEO SPEEDWAY",
            "address_2": "SUITE 102",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755442",
            "telephone_number": "425-267-9900",
            "fax_number": "425-267-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AN",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5050968",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adapthealth West, LLC
• Camillia Lily Adelstein
• Michelle Galang Akigami, PHARM.D,
• Monte James Alton, D.C.
• Lawrence Rodney Amburgy, L.M.P
• Anchor Medical Clinic
• Brandon Anderson
• Julia Katherine Anderson, P.T.
• Cris Angel, MS, DA, AEMP, HDD
• Robert Arkills

• General Practice Dentistry in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.