MR. MARK A BOUCHILLON DDS
NPI 1023109972
Dentist in Warren, MI

Q: What is Mark Bouchillon's NPI number?

The NPI number for Mark Bouchillon is 1023109972. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Q: What is Mark Bouchillon's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Bouchillon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 27, 2006PECOS Enrolled

13403 13 MILE RD, WARREN, MI 48088(586) 979-2800(586) 979-2720 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Mr. Mark A Bouchillon Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARK A BOUCHILLON DDS (NPI 1023109972) is an individual dentist in Warren, Michigan, licensed in Michigan (2901013126) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023109972

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameMR. MARK A BOUCHILLONCredential: DDS

Location Address13403 13 MILE RDWarren, MI 48088

Mailing Address13403 13 Mile RdWarren, MI 48088 · (586) 979-2800 · Fax (586) 979-2720

Phone(586) 979-2800

Fax(586) 979-2720

Sole ProprietorNo

Enumeration DateSeptember 27, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1023109972 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MI · 2901013126

Definition

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.

13403 13 MILE RD, Warren, MI 48088

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Mark A Bouchillon Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48088 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JONATHAN HURST DDS

Dentist