Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1801889209 Individual Practitioner Male Practitioner

Dr. Mark Wiatt , DDS

Dentist • T Or C, NM

Professional Overview & Biography Verified Profile Summary

Dr. Mark Wiatt, DDS is a registered healthcare professional specializing in Dentist in T Or C, NM. Practice services are available at 1960 N DATE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1960 N Date St

T Or C, NM 879013701

Telephone 5052673088
Fax 5052671747
Associated Practice Facility / Clinic
🏢 Ben Archer Health Center Facility NPI 1831352533

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in T Or C, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
2 Specialists

Practicing in T Or C, NM (630 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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License NM DD-2602

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
92422071 (NM)

Practice Associates & Co-Workers

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

11 Associated Practitioners
Carol Renninger , LISW

Counselor - Mental Health

NPI 1023001013

Licensed Independent Social Worker

NPI 1154314177

Doctor of Dental Surgery

Fernando Lugo

Family Medicine

NPI 1225021389
Ester Armijo , LMSW

Social Worker

NPI 1316135445

Licensed Master Social Worker

Lauri Greis , CNP

Nurse Practitioner

NPI 1356334999

Certified Nurse Practitioner

Dr. Roberta Stellman , MD

Psychiatry & Neurology - Psychiatry

NPI 1417988890

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active December 18, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location December 18, 2007

Registered at 1960 N DATE ST, T OR C, NM 879013701 (Tel: 5052673088)

📍
Updated Business Mailing Address December 18, 2007

Registered at 255 HWY 187, PO BOX 370, HATCH, NM 879370730 (Tel: 5052673088)

👤
Provider Name / Credentials Updated December 18, 2007

Recorded as MARK WIATT, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 18, 2007

Dentist (License #DD-2602 in NM)

🟢
Initial NPI Registration & Enumeration August 31, 2005

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: 1801889209
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 31, 2005
Last Update: December 18, 2007
Sole Proprietor: No

Mailing Address

255 Hwy 187, Po Box 370

Hatch, NM 879370730

Phone: 5052673088

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.