John Mark Oliver, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7312 Issued in NC

Practice address

2621 New Walkertown Rd
Winston Salem, NC 27101-1948

Phone

(336) 724-5054

Fax

(336) 724-5033

NPI assigned

Jan 15, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• J Mark Oliver DDS PA

  • General Practice Dentistry
  • Winston Salem, NC
  • NPI 1306933635
  NPD (past) Authorized official

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1851442073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 NEW WALKERTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271011948",
            "telephone_number": "336-724-5054",
            "fax_number": "336-724-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 NEW WALKERTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271011948",
            "telephone_number": "336-724-5054",
            "fax_number": "336-724-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "90168",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990168",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Carol Oldham, PHARM.D.
• Oldtown Immediate Care, PA
• Karen Susan Oles, PHARMD, RPH
• Michael Oliphant, MD
• Jennifer Betts Oliver, D.O,
• Pamela Alston Oliver, M.D.
• Sade Kierra Oliver
• Tonya Oliver, R.N.C., MSN, NNP
• Cristina Fernanda Olivo Freites, MD
• Kayla Madison Olmedo, LCMHCA

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.