Active NPI
Mark Edward Rettstatt, DDS
- Dentist
- Sunbury, OH
National Provider Identifier
1982532933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.028423
- Practice address
- 257 W Granville St
Sunbury, OH 43074-9684 - Phone
- (740) 480-2015
- NPI assigned
- May 11, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.028423 | OH | Primary |
Addresses
Primary practice location
257 W Granville St
Sunbury, OH 43074-9684
Mailing address
257 W Granville St
Sunbury, OH 43074-9684
Phone (740) 480-2015
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30.028423 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1982532933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 W GRANVILLE ST",
"city": "SUNBURY",
"state": "OH",
"postal_code": "430749684",
"telephone_number": "740-480-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 W GRANVILLE ST",
"city": "SUNBURY",
"state": "OH",
"postal_code": "430749684",
"telephone_number": "740-480-2015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETTSTATT",
"first_name": "MARK",
"middle_name": "EDWARD",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-11",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.028423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunbury, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.