DR. MARK E HAVERKORN (NPI# 1568672996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568672996 |
| Entity Type | Individual |
| Full Name | DR. MARK E HAVERKORN |
| Credential | DDS, MD |
| Practice Address |
5418 N Loop 1604 E Suite 101 San Antonio TX 78249-5463 |
| Practice Telephone | 2107780002 |
| Mailing Telephone | 2107780002 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2018-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
23739 | TX | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | N4460 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
5418 N LOOP 1604 E SUITE 101 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78249-5463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063987626 | River City Oral and Maxillofacial Surgery, Pllc | Clinic/Center | 5418 N Loop 1604 E, Suite 101, San Antonio, TX 78023 | 2018-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222663 | Zachary Mitchell Kimo Mitsui | Specialist/Technologist | 7311 Bluestone Rd, San Antonio, TX 78249 | 2020-10-15 |
| 1538770839 | Go Operations 3 LLC | Skilled Nursing Facility | 4366 Lockhill Selma, Shavano, TX 78249 | 2020-08-11 |
| 1417566548 | Heenaben Jayantilal Rathod | Registered Nurse | 5803 Utsa Blvd, Apt #2101, San Antonio, TX 78249 | 2020-07-24 |
| 1306455530 | Z-pediatrics Pllc | Pediatrics | 5886 Dezavala Rd Suite 101 #510, San Antonio, TX 78249 | 2020-07-23 |
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1265071203 | Caralyne Sandquist | Physician Assistant | 5510 Presidio Parkway, Building #2 Suite 2401, San Antonio, TX 78249 | 2019-12-21 |
| 1104472935 | Adam J Gordon | Social Worker | 6363 Dezavala Rd, San Antonio, TX 78249 | 2019-08-16 |
| 1336700582 | Michael Leland Post | Specialist/Technologist | 5150 Dezavala, San Antonio, TX 78249 | 2019-06-27 |
| 1043788722 | Stephen John Reynolds | Counselor | 5907 Trent Rnch, San Antonio, TX 78249 | 2018-11-11 |
| 1396211504 | Christina Michelle Morales | Specialist/Technologist | 4533 N Loop 1604 E, Ste 1119, San Antonio, TX 78249 | 2018-10-16 |
| Find all providers in zip 78249 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1023596061 | Albert L. Ouellette, Dds, Pllc | Dentist | 1202 E Sonterra Blvd Ste 801, San Antonio, TX 78258-4095 | 2018-08-01 |
| 1154726131 | Rafael Antonio Gavilanes | Dentist | 1005 Ave General Ramey Ste 1, San Antonio, PR 00690 | 2014-11-03 |
| 1952710949 | Ryan M Leonhart Dds Md Pllc | Dentist | 6530 W Loop 1604 N, Suite 101, San Antonio, TX 78254-6319 | 2014-08-05 |
| 1023424090 | Jabir Alhumaid | Dentist | 7703 Floyd Curl Dr # Mc7908, Oral and Maxillofacial Surgery Uthscsa, San Antonio, TX 78229-3901 | 2014-07-10 |
| 1013292614 | Glen A Fritz | Dentist | 16789 N Us Highway 281, Your Ortho Team, PC, San Antonio, TX 78232-2349 | 2011-10-14 |
| 1699065383 | Patricia E. Lopez | Dentist | 7703 Floyd Drive - Dept. Oral & Maxillofacial Surgery, University of Texas Health Science Center At San Antoni, San Antonio, TX 78229-3900 | 2011-04-14 |
| 1962734160 | J. Andrew Jackson, D.d.s. Ltd., LLP | Dentist | 600 Division, Suite E., San Antonio, TX 78214 | 2010-02-12 |
| 1508097817 | Daniel Enrique Perez | Dentist | 8210 Floyd Curl Dr Dept Oral, San Antonio, TX 78229-3923 | 2009-08-04 |
| 1871787291 | Adam Joseph Verrett | Dentist | 4499 Medical Dr Ste 190, San Antonio, TX 78229-3768 | 2007-08-29 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78249 |
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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.