MARK WILLIS II DMD
NPI 1114810991
Dentist - General Practice in Peachtree City, GA

Q: What is Mark Willis's NPI number?

The NPI number for Mark Willis is 1114810991. It was assigned to this individual provider in the NPPES registry on May 31, 2025.

Q: What is Mark Willis'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 Willis was last updated on May 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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 May 31, 2025

2513 REDWINE RD STE C, PEACHTREE CITY, GA 30269(770) 362-5569 Get Directions Write a Review

NPPES record last updated: May 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mark Willis Ii Dmd NPPES

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

MARK WILLIS II DMD (NPI 1114810991) is an individual general practice provider in Peachtree City, Georgia, licensed in Georgia (DN123776) and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1114810991

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameMARK WILLIS IICredential: DMD

Location Address2513 REDWINE RD STE CPeachtree City, GA 30269-4420

Mailing Address1250 Rockaway RdSenoia, GA 30276-1315 · (770) 362-5569

Phone(770) 362-5569

Sole ProprietorYes

Enumeration DateMay 31, 2025

NPPES CertifiedMay 31, 2025

✔ NPI 1114810991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in GA · DN123776

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.

2513 REDWINE RD STE C, Peachtree City, GA 30269

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Other Providers at the Same Location NPPES 2

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

DR. GATLIN GLOVER DMD

Dentist

2513 REDWINE RD STE C
PEACHTREE CITY, GA 30269

Fayette County (662) 820-0811

DR. JANICE CARMEN PARK DMD

Dentist (General Practice)

2513 REDWINE RD STE C
PEACHTREE CITY, GA 30269

Fayette County (770) 486-1984

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 Willis's NPI number?

The NPI number for Mark Willis is 1114810991. It was assigned to this individual provider in the NPPES registry on May 31, 2025.

Where is Mark Willis located?

Mark Willis practices at 2513 Redwine Rd Ste C, Peachtree City, GA 30269. The listed phone number is (770) 362-5569.

What is Mark Willis's specialty?

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

When was this NPI record last updated?

The NPPES record for Mark Willis was last updated on May 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.