1. Home
  2. Directory
  3. California
  4. Petaluma
  5. Dentist
  6. NPI Profile

DR. MARK JOHN NIZIBIAN D.D.S.
NPI 1023386638
Dentist in Petaluma, CA

Active since December 09, 2011PECOS Enrolled
1122 B ST, PETALUMA, CA 94952(707) 763-1688(707) 763-5152 Get Directions Write a Review

NPPES record last updated: December 9, 2011. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Mark John Nizibian D.d.s. NPPES

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

DR. MARK JOHN NIZIBIAN D.D.S. (NPI 1023386638) is an individual dentist in Petaluma, California, licensed in California (DA 034394) and active in the NPI registry since December 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023386638
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. MARK JOHN NIZIBIANCredential: D.D.S.
Location Address1122 B STPetaluma, CA 94952-4055
Mailing Address1122 B StPetaluma, CA 94952-4055 · (707) 763-1688 · Fax (707) 763-5152
Phone(707) 763-1688
Fax(707) 763-5152
Sole ProprietorYes
Enumeration DateDecember 9, 2011
✔ NPI 1023386638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · DA 034394
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.
1122 B ST, Petaluma, CA 94952
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark John Nizibian D.d.s. 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 94952 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
$96.16 typical visit price
range $63.04 – $187.01
Typical copayment $24.04 (range $15.76 – $46.75)
Most-billed visit code 99203
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Nizibian's NPI number?

The NPI number for Mark Nizibian is 1023386638. It was assigned to this individual provider in the NPPES registry on December 9, 2011.

Where is Mark Nizibian located?

Mark Nizibian practices at 1122 B St, Petaluma, CA 94952. The listed phone number is (707) 763-1688.

What is Mark Nizibian's specialty?

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

Is Mark Nizibian enrolled in Medicare?

Yes. Mark Nizibian is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Nizibian was last updated on December 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.