Dr. Mark E. Wilner, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11389 Issued in MA

Legal business name

DR. MARK E. WILNER, DDS

Practice address

225 Boston St
Suite 207
Lynn, MA 01904-3137

Phone

(781) 595-2542

Fax

(781) 595-5401

NPI assigned

Mar 26, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Diane L Holey

Title

Office Manager

Phone

(781) 595-2542

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1477725844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BOSTON ST",
            "address_2": "SUITE 207",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019043137",
            "telephone_number": "781-595-2542",
            "fax_number": "781-595-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BOSTON ST",
            "address_2": "SUITE 207",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019043137",
            "telephone_number": "781-595-2542",
            "fax_number": "781-595-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK E. WILNER, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "HOLEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "781-595-2542",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "11389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0246174",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Lynn, MA
• Providers in Lynn, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.