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

DR. MARK FREDERICK PULTMAN D.D.S.
NPI 1053352039
Dentist - General Practice in Bridgeton, MO

Q: What is Mark Pultman's NPI number?

The NPI number for Mark Pultman is 1053352039. It was assigned to this individual provider in the NPPES registry on June 9, 2006. The provider is also known as Dr. Mark Frederick Pultman.

Q: What is Mark Pultman's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Mark Pultman was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 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 June 09, 2006

12758 BOENKER LN, BRIDGETON, MO 63044(314) 739-3300(314) 739-0005 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Mark Frederick Pultman D.d.s. NPPES

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

DR. MARK FREDERICK PULTMAN D.D.S. (NPI 1053352039) is an individual general practice provider in Bridgeton, Missouri, licensed in Missouri (11328) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1053352039

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. MARK FREDERICK PULTMANCredential: D.D.S.

Location Address12758 BOENKER LNBridgeton, MO 63044-2436

Mailing Address12758 Boenker LnBridgeton, MO 63044-2436 · (314) 739-3300 · Fax (314) 739-0005

Phone(314) 739-3300

Fax(314) 739-0005

Sole ProprietorNo

Enumeration DateJune 9, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1053352039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MO · 11328

Definition

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.

12758 BOENKER LN, Bridgeton, MO 63044

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Other Names 1

Other Name (5)Dr. Mark Frederick Pultman

Other Providers at the Same Location NPPES 9

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

DR. WILLIAM GORDON DEWERT D.M.D.

Dentist (General Practice)