DR. MARK EDWARD GUSTAFSON (NPI# 1114033214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114033214 |
| Entity Type | Individual |
| Full Name | DR. MARK EDWARD GUSTAFSON |
| Credential | D.D.S. |
| Practice Address |
3431 Commerce Parkway Suite A Wooster OH 44691 |
| Practice Telephone | 3302648973 |
| Practice Fax Number | 3302623072 |
| Mailing Telephone | 3302648973 |
| Mailing Fax Number | 3302623072 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2009-09-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
30-01-7218 | OH | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
30-017218 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0518836 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306919931 | Mark Charles Gustafson | Chiropractor | 3916 W 113th St, Bloomington, MN 55437-3503 | 2006-11-15 |
| 1467439000 | Mark D. Gustafson | Family Medicine | 115 10th Ave Ne, Deer River, MN 56636-8795 | 2005-12-26 |
| 1346633492 | Mark Gustafson | Pharmacist | 494 Butternut Dr, Holland, MI 49424-1556 | 2015-03-13 |
| 1851667000 | Mark Leroy Gustafson | Emergency Medicine | 3110 Maccorkle Ave Se, Charleston, WV 25304-1210 | 2012-03-31 |
| 1134108756 | Mark Gustafson | Obstetrics & Gynecology | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2006-01-12 |
| Street Address |
3431 COMMERCE PARKWAY SUITE A |
| City | WOOSTER |
| State | OH |
| Zip Code | 44691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285296426 | Teddi Lynn Beun | Home Health Aide | 337 West North Street, Suite 1, Wooster, OH 44691 | 2019-07-08 |
| 1285102418 | Samantha M Rodman | Case Manager/Care Coordinator | 2858 Back Orrville Road, Wooster, OH 44691 | 2018-11-06 |
| 1205347028 | Progressive Wooster LLC | Skilled Nursing Facility | 1700 E Smithville Wester Rd, Wooster, OH 44691 | 2017-10-19 |
| 1619357563 | Michelle L Morton | Counselor | 439 N Market St Ste B, Wooster, OH 44691 | 2015-06-05 |
| 1003295502 | Walter Blair Geho | Internal Medicine | 533 Beechwood Street, Wooster, OH 44691 | 2015-05-29 |
| 1578960589 | Beth Gaubatz | Psychologist | 375 South Smyser Road, Wooster, OH 44691 | 2014-11-20 |
| 1184039729 | Diane Woodruff | Licensed Practical Nurse | 1605 Lemar Dr, Wooster, OH 44691 | 2014-06-23 |
| 1003257312 | Stacy Marie Scheibert | Licensed Practical Nurse | 639 Robinson Road, Wooster, OH 44691 | 2013-07-15 |
| 1487905972 | Judy Kropf | Counselor | 104 Spink Street, Wooster, OH 44691 | 2012-09-25 |
| 1295080752 | Brittany J Mowrer | Home Health Aide | 3570 W Smithville Western Rd, Wooster, OH 44691 | 2012-07-19 |
| Find all providers in zip 44691 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306081088 | Alexander Difilippo, D.d.s., Inc. | Dentist | 178 E Milltown Rd, Wooster, OH 44691-1244 | 2008-12-09 |
| 1235349606 | Steven Howard Miller | Dentist | 621 Quinby Ave, Wooster, OH 44691-2831 | 2007-05-23 |
| 1275755050 | Christopher R Pesicek | Dentist | 1457 Burbank Rd, Wooster, OH 44691-2325 | 2007-05-02 |
| 1881729218 | Anthony J Biggio | Dentist | 325 S Market St, Wooster, OH 44691 | 2007-02-23 |
| 1154456465 | Michael E Miller | Dentist | 325 S Market Street, Wooster, OH 44691 | 2007-02-23 |
| 1639231988 | Ferenc Relle | Dentist | 1706 Beall Ave Ste D, Wooster, OH 44691-2378 | 2006-12-14 |
| 1053366245 | William A Fischer IIi | Dentist | 3874 Burbank Rd, Wooster, OH 44691 | 2006-05-24 |
| 1104828680 | Krikor P. Ghazarian | Dentist | 130 S Market St, Wooster, OH 44691-4839 | 2005-08-13 |
| 1093710204 | Michael F. Baus | Dentist | 1724 Beall Ave, Wooster, OH 44691-2344 | 2005-06-15 |
| 1104350693 | Nicholas Nutile | Dentist | 325 S Market St, Wooster, OH 44691-4760 | 2017-04-12 |
| Find all providers in WOOSTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.