NPIMap

Organization Active NPI

Mark a Riese DDS PC

  • Dental Clinic/Center
  • Monticello, IN
National Provider Identifier
1538858501
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MARK A RIESE DDS PC
Practice address
401 W Broadway St
Monticello, IN 47960-2004
Phone
(574) 583-5042
NPI assigned
May 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Mark A Riese, DDSNPI 1043230782
Title
Dentist/Owner
Phone
(574) 583-5042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

401 W Broadway St
Monticello, IN 47960-2004

Mailing address

401 W Broadway St
Monticello, IN 47960-2004
Phone (574) 583-5042

National Provider Directory

National Provider Directory

Locations

401 W Broadway St
Monticello, IN 47960
Phone (574) 583-5042

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1538858501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W BROADWAY ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602004",
            "telephone_number": "574-583-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W BROADWAY ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602004",
            "telephone_number": "574-583-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A RIESE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "RIESE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "574-583-5042",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.