Individual provider Active NPI

Mark McGill

  • General Practice Dentistry
  • Manchester, IA
National Provider Identifier
1447550108
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
TP-0138 Issued in IA
Practice address
825 E Main St
Manchester, IA 52057-1838
Phone
(513) 283-2257
NPI assigned
Oct 28, 2010
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7332 WA
Dentist 122300000X DE00007332 WA
General Practice Dentistry 1223G0001X TP-0138 IA Primary

Addresses

Primary practice location

825 E Main St
Manchester, IA 52057-1838

Mailing address

PO Box 190
Toppenish, WA 98948-0190
Phone (509) 865-2395

Other practice location 1

602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone (509) 248-3334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212002068 WA Practitioner - Dentist 3577099654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7332WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Oct 14, 2024 Accepting new patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Oct 14, 2024 Accepting new patients

Locations

2205 W Lincoln Ave
Yakima, WA 98902
Phone (509) 469-6305

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

602 E Nob Hill Blvd
Yakima, WA 98901
Phone (509) 248-3334

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1447550108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-865-2395",
            "fax_number": "509-865-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571838",
            "telephone_number": "513-283-2257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 E Nob Hill Blvd",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989013534",
            "country_code": "US",
            "telephone_number": "509-248-3334",
            "fax_number": "509-453-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7332",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00007332",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "TP-0138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, IA

Sources for this page

Verify at the official NPI Registry.