Mark E. Wohlford, DDS, PH D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12009501A Issued in IN

Practice address

405 Bentee Wes CT.
Evansville, IN 47715-4061

Phone

(812) 401-3500

Fax

(812) 401-3600

NPI assigned

Apr 28, 2006

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

Enrolled in IN

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

Doctor of Philosophy

State licenses

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.

• Tri-State Oral Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Evansville, IN
  • NPI 1710366323
  NPD (past) Authorized official
• Indiana University

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552

  Oral and Maxillofacial Surgery

  NPD (past)
• Oral Surgery Group of Evansville, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Evansville, IN
  • NPI 1467506188
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1811954076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BENTEE WES CT.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154061",
            "telephone_number": "812-401-3500",
            "fax_number": "812-401-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BENTEE WES CT.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154061",
            "telephone_number": "812-401-3500",
            "fax_number": "812-401-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHLFORD",
        "first_name": "MARK",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS, PH D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12009501A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100120750C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Witte, PTA
• John B Wittgen, DDS
• Deandra Wittmer, DPT
• Margaret A Wittmer, AU.D.
• Renee L Woebkenberg, ATC
• Christine E Wolf, RN
• Erin Alise Wolf, PA-C
• Michael Christopher Wolf, DDS
• Hailee M Wolfe, MSW
• Malea Dawn Wolfe, ACNP-BC

• Oral and Maxillofacial Surgery (Dentist) in Evansville, IN
• Providers in Evansville, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.