Mark D. Schenkman, D.D.S.
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Attleboro Falls, MA
NPI 1609987338 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609987338
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 21387 (MA)
- Practice address
- 103 Commonwealth Ave
Attleboro Falls, MA 02763-1015 - Phone
- (508) 699-0449
- Fax
- (508) 699-4344
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- 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 |
|---|---|---|---|---|
| I20221227001322 | AZ | Order and Referring Only - Oral Surgery |
9234161654 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN02881 | RI | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Valley Endodontics, P.a. | Past |
Accepting new patients | |
| Attleboro-Cumberland Oral Surgeons, Inc. | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
| Chan Park MD Inc | Past | Accepting new patients | |
| Ilshahuome Dental Surgery | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 21387 | MA | Yes |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DEN02881 | RI |
Addresses
Primary practice location
103 Commonwealth Ave
Attleboro Falls, MA 02763-1015
Mailing address
53 Pearl St
North Attleboro, MA 02760-6612
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0208451 | Medicaid | MA |
Other providers in Attleboro Falls, MA
- Ilshahuome Dental Surgery
- Mohamed R Ilshahuome
- Chloe Ann Mendes
- Michael Jean Pepin
- Donald A Pierce
- Sharon Areias Trahan
- Roxana Namdari Zandi
All providers in Attleboro Falls, MA · Oral and Maxillofacial Surgery (Dentist) in Massachusetts
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.