Individual provider Active NPI

Mark Samuel Zeman, DMD

  • General Practice Dentistry
  • Cumming, GA
National Provider Identifier
1669548871
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9671 Issued in GA
Practice address
103 Mountain View Dr
Suite a
Cumming, GA 30040-2400
Phone
(770) 887-0447
Fax
(770) 887-9521
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9671 GA Primary

Addresses

Primary practice location

103 Mountain View Dr
Suite a
Cumming, GA 30040-2400

Mailing address

103 Mountain View Dr
Cumming, GA 30040-2400
Phone (770) 887-0447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9671GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Dental Care General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669548871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MOUNTAIN VIEW DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402400",
            "telephone_number": "770-887-0447",
            "fax_number": "770-887-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MOUNTAIN VIEW DR",
            "address_2": "SUITE A",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402400",
            "telephone_number": "770-887-0447",
            "fax_number": "770-887-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMAN",
        "first_name": "MARK",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.