Mark Alan Ralph, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12012871A Issued in IN

Practice address

400 E Diamond Ave
Evansville, IN 47711-3714

Phone

(812) 461-2365

Fax

(812) 461-2366

NPI assigned

Oct 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 12, 2015 through Nov 12, 2027

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.

• Kool Smiles in-3, PC

  • General Practice Dentistry
  • Evansville, IN
  • NPI 1831284439
  NPD (past)
• Pullen, DMD, P.C.

  • Dentist
  • Huntsville, AL
  • NPI 1669550042
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851480628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2353 WHITESBURG DRIVE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-533-3735",
            "fax_number": "256-533-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E DIAMOND AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477113714",
            "telephone_number": "812-461-2365",
            "fax_number": "812-461-2366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2353 Whitesburg Drive",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "35801",
            "country_code": "US",
            "telephone_number": "256-533-3735",
            "fax_number": "256-533-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALPH",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "4813",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012871A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5151085",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shivalli Dharmendra Rai, PA
• Ann B Raibley, CCC-A
• Sarah Rains, OTR
• Noah Raleigh, RBT
• Ralph D Millsaps, MD, PC
• Lisa Ramey, COTA
• Raul J. Ramirez Velazquez, D.O.
• Brittany R Ramsey, NP
• Jennifer R Ramsey
• Tiffany N Ramsey, NP

• General Practice Dentistry in Evansville, IN
• Providers in Evansville, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.