Individual provider Active NPI

Mark Leonard Wiesner, D.D.S.

  • Dentist
  • Washington, DC
National Provider Identifier
1912982158
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10757 Issued in MD
Practice address
6900 Georgia Ave. NW
Building 2, Room 1D02
Washington, DC 20307-5400
Phone
(202) 782-6815
Fax
(202) 782-6987
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10757 MD Primary

Addresses

Primary practice location

6900 Georgia Ave. NW
Building 2, Room 1D02
Washington, DC 20307-5400

Mailing address

6900 Georgia Ave. NW
Building T20, Room 206a
Washington, DC 20307-5400
Phone (202) 782-0988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10757MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912982158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 GEORGIA AVE. NW",
            "address_2": "BUILDING T20, ROOM 206A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203075400",
            "telephone_number": "202-782-0988",
            "fax_number": "202-782-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 GEORGIA AVE. NW",
            "address_2": "BUILDING 2, ROOM 1D02",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203075400",
            "telephone_number": "202-782-6815",
            "fax_number": "202-782-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESNER",
        "first_name": "MARK",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "10757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.