Mark Dale Foster, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6740-15 Issued in WI

Practice address

413 N 17TH Ave
Wausau, WI 54401-4226

Phone

(715) 842-4649

NPI assigned

Oct 13, 2011

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1497030100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 CANVASBACK LN",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019146",
            "telephone_number": "414-581-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N 17TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014226",
            "telephone_number": "715-842-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "MARK",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DDS  MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6740-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Forbes Kearns, MS,ARNP-C
• Forefront Dermatology, S.C.
• Forge Prosthetics, LLC
• Travis Jon Forst, MSW, LCSW
• Jeffrey Allan Foster, DDS, MS
• Cody Fox, MD
• Emily A Fox, LPC-IT
• Julie Fox, D.D.S.,S.C.
• Robert R Fox, LPC
• Stephen P Fox, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Wausau, WI
• Providers in Wausau, WI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.