DR. JEFFREY ALAN MARK (NPI# 1609966324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609966324 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY ALAN MARK |
| Credential | D.M.D.,M.S |
| Practice Address |
20950 N Tatum Blvd Suite 370 Phoenix AZ 85050-4200 |
| Practice Telephone | 4805150660 |
| Practice Fax Number | 4805634846 |
| Mailing Telephone | 4805150660 |
| Mailing Fax Number | 4805634846 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
6070 | AZ | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689126724 | Jeffrey Mark | Dentist | 4801 S Cliff Ave Ste 208, Independence, MO 64055-6954 | 2016-10-25 |
| 1487946240 | Jeffrey Mark | Counselor | 100 Rosaschi Rd, Yerington, NV 89447-8722 | 2011-05-11 |
| 1487603155 | Jeffrey C Mark | Internal Medicine | 2101 Geer Rd, Suite #118, Turlock, CA 95382-2454 | 2006-05-09 |
| Street Address |
20950 N TATUM BLVD SUITE 370 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85050-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982604708 | Steven Cary Simon | Surgery | 20950 N Tatum Blvd, Suite 308, Phoenix, AZ 85050-4200 | 2005-07-22 |
| 1689110314 | Trusted Care Surgery Centers LLC | Clinic/Center | 20950 N Tatum Blvd, Suite 170, Phoenix, AZ 85050-4200 | 2017-01-19 |
| 1790141224 | Cheryl Schaaf | Registered Nurse | 20950 N Tatum Blvd, Suite 150, Phoenix, AZ 85050-4200 | 2016-01-13 |
| 1659749190 | Micheal Papademetriou | Dentist | 20950 N Tatum Blvd, 370, Phoenix, AZ 85050-4200 | 2015-09-14 |
| 1124427828 | Derrick A. Debenedetto | Physical Therapist | 20950 N Tatum Blvd, Ste. 100, Phoenix, AZ 85050-4200 | 2014-08-19 |
| 1770997413 | Kaitlyn Kakar | Physical Therapist | 20950 N Tatum Blvd, Suite 100, Phoenix, AZ 85050-4200 | 2014-06-19 |
| 1568874683 | Az Pain Consultants LLC | Pain Medicine | 20950 N Tatum Blvd, Suite 220, Phoenix, AZ 85050-4200 | 2014-05-22 |
| 1215363320 | Desert Ridge Oral,facial & Implant Surgery, Pllc | Dentist | 20950 N Tatum Blvd, Suite 120, Phoenix, AZ 85050-4200 | 2013-09-20 |
| 1427490242 | Lauren K. Hasquet | Physical Therapist | 20950 N Tatum Blvd, Suite 100, Phoenix, AZ 85050-4200 | 2013-07-22 |
| 1588960512 | Desert Ridge Implant & Oral Surgery PC | Dentist | 20950 N Tatum Blvd, Ste. 120, Phoenix, AZ 85050-4200 | 2011-02-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045528 | Jesse Micheal Stokke | Student in an Organized Health Care Education/Training Program | Honorhealth Jomax Clinic, 26224 N. Tatum Blvd. #5, Phoenix, AZ 85050 | 2019-04-02 |
| 1386104974 | Dania Aijaz Shah | Student in an Organized Health Care Education/Training Program | Honor Health Jomax Clinic, 26224 N. Tatum Blvd. #5, Phoenix, AZ 85050 | 2019-03-21 |
| 1205391588 | Sanctuary | Clinic/Center | 2550 E Rose Garden Ln, # 73404, Phoenix, AZ 85050 | 2019-01-31 |
| 1477026474 | Archer Health LLC | Nurse Practitioner | 21001 N Tatum Blvd Ste 1630 - 490, Phoenix, AZ 85050 | 2019-01-02 |
| 1548756059 | Preston Andrew Slade | Community/Behavioral Health | 20860 E. Tatum Blvd Ste, 300, Phoenix, AZ 85050 | 2018-07-09 |
| 1184126658 | Alisha Ramirez | Specialist/Technologist | 19638 N 37th Way, Phoenix, AZ 85050 | 2018-03-01 |
| 1720590011 | Dr Richards Pllc | Internal Medicine | 20815 N 25th Pl Ste A106, Phoenix, AZ 85050 | 2017-10-26 |
| 1417474792 | Heather Arabeity | Nurse Practitioner | 3762 E Zachary Dr, Phoenix, AZ 85050 | 2017-08-28 |
| 1083161087 | Haley Elaine Kinzer | Physician Assistant | 20950 N Tatum Blvd Ste 150, Phoenix, AZ 85050 | 2016-09-07 |
| 1003227927 | Chelsea Joy Thomsen | Internal Medicine | 26224 N Tatum Blvd Ste 7, Phoenix, AZ 85050 | 2014-05-13 |
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| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558924415 | Ahwatukee Orthodontic Associates Inc | Dentist | 16611 S. 40th Street, Suite 110, Phoenix, AZ 85048 | 2019-04-17 |
| 1538636766 | David Hoffman Phoenix Orthodontics PC | Dentist | 5225 N 19th Ave Ste 8, Phoenix, AZ 85015-2903 | 2018-10-25 |
| 1881169233 | Smile Straight Orthodontics - Greenway LLC | Dentist | 3229 E Greenway Rd Ste 101, Phoenix, AZ 85032-4508 | 2018-10-11 |
| 1336656024 | Andrew Philip Serrano | Dentist | 1515 E Missouri Ave Ste 101, Phoenix, AZ 85014-2443 | 2018-01-04 |
| 1659829299 | The Smyl Co | Dentist | 10 W Adams St, Phoenix, AZ 85003-2025 | 2016-09-12 |
| 1932537131 | Jenny Sun | Dentist | 3425 W Thunderbird Rd, Suite 1, Phoenix, AZ 85053-5670 | 2013-10-24 |
| 1053753228 | North Valley Orthodontics Pllc | Dentist | 21050 N Tatum Blvd Ste D202, Phoenix, AZ 85050-4260 | 2013-07-29 |
| 1679823264 | Hemali Kothari | Dentist | 124 W Thomas Rd Ste 320, Phoenix, AZ 85013-4415 | 2012-09-12 |
| 1861720302 | Mark Kenneth Mcalister | Dentist | 702 East Bell Road, #100, Phoenix, AZ 85022 | 2009-11-20 |
| 1841434461 | Daniel S Blue | Dentist | 224 West San Juan Avenue, Phoenix, AZ 85013 | 2009-04-27 |
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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.