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Deactivated NPI 1093707523 Deactivated / Inactive NPI Male Practitioner

Dr. Mark E Wilson , DDS

Dentist - General Practice • Pauls Valley, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 19, 2005
NPI Deactivation Date March 22, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Mark Wilson, DDS was a registered Dentist - General Practice practicing in Pauls Valley, OK. Throughout an active medical career spanning 17 years, Dr. Wilson provided care at the practice location at 101 MILLER DR until profile deactivation on 2022-03-22.

Practice Location & Contact Primary Location

Practice Address

101 Miller Dr

Pauls Valley, OK 730756412

Telephone 4052382574
Fax 4052382556
Associated Practice Facility / Clinic
🏢 Valley Dental Group Pllc Facility NPI 1437623808

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Pauls Valley, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
4 Specialists

Practicing in Pauls Valley, OK (1496 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OK OK4136

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

3 Associated Practitioners
Dr. Shane Fehrenbach , DDS

Dentist - General Practice

NPI 1164149605

Doctor of Dental Surgery

NPI 1558110676

Doctor of Dental Surgery

NPI 1770804932

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated March 22, 2022

Record deactivated on March 22, 2022

NPI Profile Active October 03, 2007

NPI status registered as active in NPPES database

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Updated Practice Location October 03, 2007

Registered at 101 MILLER DR, PAULS VALLEY, OK 730756412 (Tel: 4052382574)

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Updated Business Mailing Address October 03, 2007

Registered at PO BOX 357, PAULS VALLEY, OK 730750357 (Tel: 4052382574)

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Provider Name / Credentials Updated October 03, 2007

Recorded as MARK WILSON, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2007

Dentist (License #OK4136 in OK)

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Initial NPI Registration & Enumeration August 19, 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: 1093707523
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2005
Last Update: October 03, 2007
Deactivation Date: March 22, 2022

Mailing Address

Po Box 357

Pauls Valley, OK 730750357

Phone: 4052382574

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.