Mark Earl Conover

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9128 Issued in MN

Practice address

402 Sunrise Dr
Saint Peter, MN 56082-1342

Phone

(507) 931-1230

Fax

(507) 931-1493

NPI assigned

Aug 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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 Dec 20, 2015 through Dec 20, 2027

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.

• St Peter Family Dental Center, P.a.

  • General Practice Dentistry
  • Saint Peter, MN
  • NPI 1215042445
  NPD (past) Authorized official

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437264694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 SUNRISE DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821342",
            "telephone_number": "507-931-1230",
            "fax_number": "507-931-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SUNRISE DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821342",
            "telephone_number": "507-931-1230",
            "fax_number": "507-931-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONOVER",
        "first_name": "MARK",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lyn Carlstrom, LICSW
• Ellen Reinhard Castillo, PHD
• Christopher Caven, PHARMD
• Justin Angel Coates, LPC
• Community Behavioral Health Hospital-St Peter (CBHH-St Peter)
• Jacqueline Rose Cooper, RN, CNP
• Cornerstone Wellness Center of St.Peter P.a.
• Counseling Services of Southern Minnesota, Inc
• County of Nicollet (Nicollet County Human Services)
• County of Nicollet (Nicollet County Public Health)

• General Practice Dentistry in Saint Peter, MN
• Providers in Saint Peter, MN by specialty
• General Practice Dentistry in Minnesota

• 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.
• 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.