Mark Richard Warren, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901015738 Issued in MI

Practice address

7924 Secor Road Box 297
Lambertville, MI 48144-0297

Phone

(734) 856-3004

Fax

(734) 215-2323

NPI assigned

Dec 6, 2012

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 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

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.

• Secor Dental Associates

  • Dentist
  • Lambertville, MI
  • NPI 1144291832
  NPD (past)

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1669717344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "address_2": "7924 SECOR ROAD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481440297",
            "telephone_number": "734-856-3004",
            "fax_number": "734-215-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7924 SECOR ROAD BOX 297",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481440297",
            "telephone_number": "734-856-3004",
            "fax_number": "734-215-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015738",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-01-8652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger A True, MD
• Isaac Villa, P.T.
• Walgreen Co
• Hannah Walker, LPC
• Grace Yiwen Wang, M.D.
• Matthew Weeks, PHARMD, RPH
• Marlene Calderon Welch, M.D.
• Jessica B Wenzel, CNP
• Ashley Michele White, RN
• Ashley Wilhelm, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.