1. Home
  2. Directory
  3. Wisconsin
  4. Green Bay
  5. Dentist
  6. NPI Profile

MARK BRODHAGEN DDS SC
NPI 1164500591
Dentist - General Practice in Green Bay, WI

Active since November 02, 2006
1052 BEL AIRE COURT, GREEN BAY, WI 54304(920) 499-2121(920) 499-7644 Get Directions Write a Review

NPPES record last updated: November 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 16, 2016, Oct 24, 2016 (2 updates tracked since 2016).

About Mark Brodhagen Dds Sc NPPES

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

MARK BRODHAGEN DDS SC (NPI 1164500591) is a healthcare organization registered as a general practice in Green Bay, Wisconsin and active in the NPI registry since November 2006. The organization lists Mark Andrew Brodhagen, Owner, as its authorized official.

NPPES Registry Identity

NPI1164500591
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMARK BRODHAGEN DDS SC
Location Address1052 BEL AIRE COURTGreen Bay, WI 54304
Mailing Address1052 Bel Aire CourtGreen Bay, WI 54304 · (920) 499-2121 · Fax (920) 499-7644
Phone(920) 499-2121
Fax(920) 499-7644
Organization SubpartNo
Authorized OfficialMark Andrew BrodhagenOwner · (920) 499-2121
Enumeration DateNovember 2, 2006
Last NPPES UpdateNovember 16, 20162 updates tracked since enumeration
✔ NPI 1164500591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
1052 BEL AIRE COURT, Green Bay, WI 54304
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Brodhagen Dds Sc's NPI number?

The NPI number for Mark Brodhagen Dds Sc is 1164500591. It was assigned to this organization in the NPPES registry on November 2, 2006.

Where is Mark Brodhagen Dds Sc located?

Mark Brodhagen Dds Sc is located at 1052 Bel Aire Court, Green Bay, WI 54304. The listed phone number is (920) 499-2121.

What is Mark Brodhagen Dds Sc'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 Brodhagen Dds Sc was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.