Mark Allen Myers, D.D.S.
Individual provider Active NPI General Practice Dentistry · Huron, OH
NPI 1467465732 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1467465732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 20860 (OH)
- Practice address
- 107 Bogart Rd
Huron, OH 44839-2303 - Phone
- (419) 433-2751
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150409001064 | OH | Order and Referring Only - Oral Surgery |
7012235740 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20860 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 20860 | OH | Yes |
Addresses
Primary practice location
107 Bogart Rd
Huron, OH 44839-2303
Mailing address
107 Bogart Rd
Huron, OH 44839-2303
Phone (419) 433-2751
Other providers in Huron, OH
- Kevin McCormick
- MD Imaging LLC
- Nichole L Michel
- David G. Miller
- Mary H Murphy
- Donald John Novotny
- Allison D Ontko
- Kyah Patterson
- Mary Anne Pfrogner
- Violet Piskur
All providers in Huron, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.