Individual provider Active NPI

Mark Dean Norland, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Appleton, WI
National Provider Identifier
1932735214
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
019.033056 Issued in IL
Practice address
2410 E Evergreen Dr
Appleton, WI 54913-9003
Phone
(920) 832-9500
NPI assigned
Mar 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019.033056 IL Primary

Addresses

Primary practice location

2410 E Evergreen Dr
Appleton, WI 54913-9003

Mailing address

2410 E Evergreen Dr
Appleton, WI 54913-9003
Phone (920) 832-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200806001626 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133544216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.033056ILMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Apple Creek Oral Surgery, SC Oral and Maxillofacial Surgery PastSince Jun 15, 2025 Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
Bldg 105
Maywood, IL 60153
Phone (708) 216-1676

Interoperability endpoints

  • Direct secure messaging: mnorland139896@direct.luhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1932735214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 E EVERGREEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139003",
            "telephone_number": "920-832-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 E EVERGREEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139003",
            "telephone_number": "920-832-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORLAND",
        "first_name": "MARK",
        "middle_name": "DEAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.033056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.