Mark Lewis Waltzer, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI 01380900 Issued in NJ

Practice address

1930 Marlton Pike E
Suite X-114
Cherry Hill, NJ 08003-4214

Phone

(856) 429-6412

Fax

(856) 429-6341

NPI assigned

Jul 21, 2005

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

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 Jun 17, 2021 through Jun 17, 2027

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mews Dental Associates, PC

  • General Practice Dentistry
  • Cherry Hill, NJ
  • NPI 1114435898
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1891795761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "SUITE X-114",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034214",
            "telephone_number": "856-429-6412",
            "fax_number": "856-429-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "SUITE X-114",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034214",
            "telephone_number": "856-429-6412",
            "fax_number": "856-429-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTZER",
        "first_name": "MARK",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI 01380900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Samuel Wallis, D.M.D.
• Michael Edward Walls, PT
• Gina Marie Walsh, MS, OTR/L
• Mary Walter-Barber, M.S. CCC-SLP
• Fatima L Walton
• Wanaque Operating Co, L.P. (The Wanaque Center)
• Enoch Wang, LMT
• Lona Wang
• Michael Wang, PT, DPT
• Sophia Wang, DPT

• General Practice Dentistry in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.