DR. MARK D THEBAUT DDS
NPI 1245332238
Dentist - Pediatric Dentistry in Lilburn, GA

Active since September 01, 2006
609 BEAVER RUIN RD NW, LILBURN, GA 30047(770) 925-3300(770) 925-3302 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mark D Thebaut Dds NPPES

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

DR. MARK D THEBAUT DDS (NPI 1245332238) is an individual pediatric dentistry provider in Lilburn, Georgia, licensed in Georgia (9113) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1245332238
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. MARK D THEBAUTCredential: DDS
Location Address609 BEAVER RUIN RD NWLilburn, GA 30047-3401
Mailing Address609 Beaver Ruin Rd NwLilburn, GA 30047-3401 · (770) 925-3300 · Fax (770) 925-3302
Fax(770) 925-3302
Sole ProprietorNo
Enumeration DateSeptember 1, 2006
Last NPPES UpdateJuly 9, 2007
NPI 1245332238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License Licensed in GA · 9113
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

609 BEAVER RUIN RD NW, Lilburn, GA 30047

Accepted Insurance

Other Providers at the Same Location NPPES 4

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

Dentist (Periodontics)
609 BEAVER RUIN RD NW, SUITE E
LILBURN, GA 30047
Dentist (Pediatric Dentistry)
609 BEAVER RUIN RD NW
LILBURN, GA 30047
Dentist (Pediatric Dentistry)
609 BEAVER RUIN RD NW, SUITE A
LILBURN, GA 30047
Dentist (General Practice)
609 BEAVER RUIN RD NW
LILBURN, GA 30047

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 Thebaut's NPI number?

The NPI number for Mark Thebaut is 1245332238. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Where is Mark Thebaut located?

Mark Thebaut practices at 609 Beaver Ruin Rd NW, Lilburn, GA 30047. The listed phone number is (770) 925-3300.

What is Mark Thebaut's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Mark Thebaut accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 11 other insurers list Mark Thebaut as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Thebaut was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.