Mark Franklin Kozacko, DDS PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6836 Issued in NC

Practice address

6817 Falls of Neuse Rd
Suite 101
Raleigh, NC 27615-5386

Phone

(919) 848-9871

Fax

(919) 848-7841

NPI assigned

Jun 24, 2006

Last updated

Jul 13, 2026By the provider in NPPES

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

Other identifiers 1

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 Mar 24, 2013 through Mar 24, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mkozacko128267@direct.unc.nchie.net

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.

• Mark Kozacko DDS PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Raleigh, NC
  • NPI 1114103066
  Authorized official Same address or phone

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952337685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 FALLS OF NEUSE RD",
            "address_2": "SUITE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155386",
            "telephone_number": "919-848-9871",
            "fax_number": "919-848-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 FALLS OF NEUSE RD",
            "address_2": "SUITE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155386",
            "telephone_number": "919-848-9871",
            "fax_number": "919-848-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZACKO",
        "first_name": "MARK",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "6836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC PROVIDER NUMBER",
            "identifier": "9016W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennie L Kowaleski, PA-C
• Dylan Joseph Kowalewski, PA
• Kaitlynn Donovan Kowalick, DPT
• Brooke Sandra Kowalski, MSW, LCSWA
• Maria Kowalsky
• Bryan Christopher Kozak, PA-C
• Abby Koziak
• Ayanna James Kozlow, PA-C
• Mary Kozuch, PNP
• David McKenzie Kraebber, MD

• Oral and Maxillofacial Surgery (Dentist) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• 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.
• 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.