Individual provider Active NPI

Mark D Snyder, DDS

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1912021072
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901015408 Issued in MI
Practice address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone
(734) 764-5527
Fax
(734) 763-3453
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901015408 MI Primary
General Practice Dentistry 1223G0001X 2901015408 MI

Addresses

Primary practice location

1011 N University Ave
Ann Arbor, MI 48109-1078

Mailing address

1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 764-5527

Other identifiers 2

IdentifierTypeStateIssuer
D154080OtherMIBCBS OF MI DENTAL
1958162910OtherMIBCBS OF MI MED SURGICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20150921002527 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648587832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1912021072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-5527",
            "fax_number": "734-763-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-5527",
            "fax_number": "734-763-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015408",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015408",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI DENTAL",
            "identifier": "D154080",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI MED SURGICAL",
            "identifier": "1958162910",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.