Mark E Haverkorn, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23739 Issued in TX

Practice address

5418 N Loop 1604 E
Suite 101
San Antonio, TX 78249-5463

Phone

(210) 778-0002

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Joseph Cecere D.M.D.,Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Worth, TX
  • NPI 1881879070
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1568672996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 N LOOP 1604 E",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782495463",
            "telephone_number": "210-778-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5418 N LOOP 1604 E",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782495463",
            "telephone_number": "210-778-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERKORN",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "N4460",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Wayne Haveman, DDS
• Haven Eyecare PLLC
• Haven Transition Solutions
• Haven Transition Solutions
• Kirby S Haverda, CRNA
• Rashel M Haverkorn, MD
• Thomas Havey
• James S Havran, C.O., L.O.
• Russell Dean Havranek, MD
• Asem Anwar Hawari, OD

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.