Mark a. Retterbush

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9831 Issued in GA

Legal business name

MARK A. RETTERBUSH

Practice address

2311 N Patterson St
Valdosta, GA 31602-2510

Phone

(229) 244-1633

Fax

(229) 244-4663

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Mark Allen Retterbush, D.M.D.

Title

Dr/ Owner

Phone

(229) 244-1633

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Meredith Spann Barker, D.M.D

  • Dentist
  • Valdosta, GA
  • NPI 1770703720
  NPD (past)

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1447487939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022510",
            "telephone_number": "229-244-1633",
            "fax_number": "229-244-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022510",
            "telephone_number": "229-244-1633",
            "fax_number": "229-244-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. RETTERBUSH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "RETTERBUSH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DR/ OWNER",
        "authorized_official_telephone_number": "229-244-1633",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000272159A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1356486575",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9181766",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Marable
• Stanley Bernard Marable, D.D.S.
• Richard A Marasco, PHARM., FASCP, CGP
• Maegan Marcinowski, RBT
• Maria C Castellano, MD, LLC
• Mark a. Roland, DMD PC
• Mark Webb LMFT PC
• Edward K Mark Jr., M.D.
• Robert Marlow Jr., LCSW
• Rasa Marozaite, BCBA

• General Practice Dentistry in Valdosta, GA
• Providers in Valdosta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.