Mark David McNiel, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3335-015 Issued in WI

Practice address

250 N Green Bay Rd
Neenah, WI 54956-2245

Phone

(920) 725-7840

Fax

(920) 725-5355

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679694558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562245",
            "telephone_number": "920-725-7840",
            "fax_number": "920-725-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562245",
            "telephone_number": "920-725-7840",
            "fax_number": "920-725-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNIEL",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3335-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33469900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas McInnis, APNP
• Seth L McIntire, DO
• Joseph Nelson McLaughlin, MD, PHD
• Joseph C McNiel, DDS
• Kathryn Marie McNiel, LMFT
• James Frederick McRae, D.C.
• Medical Transport Services, LLC
• Halie Rae Meidenbauer, OTR/L
• Jean Meissner, MSE, NCC, LPC-IT
• Mending Minds Counseling and Wellness LLC

• General Practice Dentistry in Neenah, WI
• Providers in Neenah, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.