Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1043733660 Individual Practitioner Male Practitioner

Mark Watanabe

Dentist - General Practice • Vallejo, CA

Professional Overview & Biography Verified Profile Summary

Mark Watanabe is a registered healthcare professional specializing in Dentist - General Practice in Vallejo, CA. Practice services are available at 201 WALNUT AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

201 Walnut Ave

Vallejo, CA 945921107

Telephone 7075628229
Associated Practice Facility / Clinic
🏢 Martinez Vamc Facility NPI 1780632901

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Vallejo, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
59 Specialists

Practicing in Vallejo, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-06-24
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 102904

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Tiffany Tse , DMD

Dentist - General Practice

NPI 1174156459

Doctor of Dental Medicine

Alice Lin

Student in an Organized Health Care Education/Training Program

NPI 1194647776

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Business Mailing Address June 24, 2020

Registered at 37475 BAY CREST RD, NEWARK, CA 945603554

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2020

Dentist (License #102904 in CA)

NPI Profile Active July 25, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location July 25, 2017

Registered at 201 WALNUT AVE, VALLEJO, CA 945921107 (Tel: 7075628229)

📍
Updated Business Mailing Address July 25, 2017

Registered at 20064 OAKSIDE CT, SAUGUS, CA 91390

👤
Provider Name / Credentials Updated July 25, 2017

Recorded as MARK WATANABE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration July 25, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043733660
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 25, 2017
Last Update: June 24, 2020
Sole Proprietor: Yes

Mailing Address

37475 Bay Crest Rd

Newark, CA 945603554

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.