Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MARK DOUGLAS MINTLINE DDS
NPI 1043642069
Dentist in Philadelphia, PA

Q: What is Mark Mintline's NPI number?

The NPI number for Mark Mintline is 1043642069. It was assigned to this individual provider in the NPPES registry on August 1, 2013.

Q: What is Mark Mintline's specialty?

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

Q: Is Mark Mintline enrolled in Medicare?

No. Mark Mintline has opted out of Medicare through March 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Mark Mintline was last updated on September 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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 August 01, 2013Opted out of Medicare · through Mar 31, 2028

51 N. 39TH STREET, SUITE 106 MEDICAL ARTS BUILDING, PHILADELPHIA, PA 19104(215) 662-8060(215) 243-3284 Get Directions Write a Review

NPPES record last updated: September 10, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 10, 2026, Aug 25, 2026, Oct 30, 2018 and 1 more (4 updates tracked since 2018).

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About Dr. Mark Douglas Mintline Dds NPPES

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

DR. MARK DOUGLAS MINTLINE DDS (NPI 1043642069) is an individual dentist in Philadelphia, Pennsylvania, licensed in California (62702) and active in the NPI registry since August 2013. He has opted out of Medicare through March 31, 2028.

NPPES Registry Identity

NPI1043642069

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. MARK DOUGLAS MINTLINECredential: DDS

Location Address51 N. 39TH STREET, SUITE 106 MEDICAL ARTS BUILDINGPhiladelphia, PA 19104-2640

Mailing Address51 N. 39th Street, Suite 106 Medical Arts BuildingPhiladelphia, PA 19104-2640 · (215) 662-8060 · Fax (215) 243-3284

Phone(215) 662-8060

Fax(215) 243-3284

Sole ProprietorNo

Enumeration DateAugust 1, 2013

Last NPPES UpdateSeptember 10, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 10, 2026

✔ NPI 1043642069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 62702

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.

Also ListedDentist · Oral and Maxillofacial PathologyTaxonomy 1223P0106X · License 62702 (CA), DS045628 (PA)

51 N. 39TH STREET, Philadelphia, PA 19104

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Mark Douglas Mintline Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 31, 2022 through March 31, 2028.

Opt-Out Effective DateMarch 31, 2022

Opt-Out In Effect ThroughMarch 31, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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 20

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

JONATHAN TSUI MD

Ophthalmology

51 N. 39TH STREET
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8100

DR. SHELLEY ILENE CUTLER-FRANKEL OD

Optometrist

51 N. 39TH STREET
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8100

SEAN D FOSTER MD

Emergency Medicine

51 N. 39TH STREET, -MYRIN - M01
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8214

KIM TIEN DINH MD

Ophthalmology

51 N. 39TH STREET
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8100

DARWIN D DEEN JR. MD

Family Medicine

51 N. 39TH STREET, 7TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8777

JENNY C LE PA-C

Physician Assistant (Medical)

51 N. 39TH STREET, 3 SILVERSTEIN
PHILADELPHIA, PA 19104

Philadelphia County (215) 294-9456

DAVID H JANG MD

Emergency Medicine

51 N. 39TH STREET
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8214

MS. GINA MARIE POPPITI PA-C

Physician Assistant (Surgical)

51 N. 39TH STREET
PHILADELPHIA, PA 19104

Philadelphia County (215) 294-9456

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 Mintline's NPI number?

The NPI number for Mark Mintline is 1043642069. It was assigned to this individual provider in the NPPES registry on August 1, 2013.

Where is Mark Mintline located?

Mark Mintline practices at 51 N. 39th Street Suite 106 Medical Arts Building, Philadelphia, PA 19104. The listed phone number is (215) 662-8060.

What is Mark Mintline's specialty?

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

Is Mark Mintline enrolled in Medicare?

No. Mark Mintline has opted out of Medicare through March 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mark Mintline was last updated on September 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.