Mark Ronald Mortiere, M.S.,D.D.S., P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

2901014491 Issued in MI

Practice address

18883 Glengarry Dr
Livonia, MI 48152-8099

Phone

(586) 747-2273

Fax

(248) 473-2553

NPI assigned

Jul 24, 2006

Last updated

Jun 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1659393114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18883 GLENGARRY DR",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481528099",
            "telephone_number": "586-747-2273",
            "fax_number": "248-473-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18883 GLENGARRY DR",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481528099",
            "telephone_number": "586-747-2273",
            "fax_number": "248-473-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTIERE",
        "first_name": "MARK",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.S.,D.D.S., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901014491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary (Mitsy) E Morris
• Michael Morris, M.A.
• Alyssa Morrison
• Jennifer Lynn Morrow, MS
• Shardaya Morse
• Lindsy Mosby-Osman, LLMSW
• Valerie Cristina Moscoso, DO
• Holly Kay Moser, CNM, FNP
• Chanel Moses-Hearn
• Mersedeh Moshfeghi, PHARM.D.

• Dentist in Livonia, MI
• Providers in Livonia, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.