Mark Allan Osenieks, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901016297 Issued in MI

Practice address

O-11225 Tallmadge Woods Dr NW
Grand Rapids, MI 49534-6313

Phone

(616) 453-0002

NPI assigned

Dec 27, 2006

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

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1912062902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 TALLMADGE WOODS DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495346306",
            "telephone_number": "616-453-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "O-11225 TALLMADGE WOODS DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495346313",
            "telephone_number": "616-453-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSENIEKS",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Payton S Osborne
• Theresa Ann Osborne, MD
• Alexzia Osech
• Emmanuel Osei Kuffuor
• Julieta Osella, MD
• Lara Mariel Osetinsky, M.D.
• Analise Virginia Osgood, LMSW
• Nicole Osier, LLMSW
• Caroline Oska, M.D.
• Alen Osmanagic

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.