MARK M. WIDLOSKI DDS
NPI 1285631135
Dentist - Oral and Maxillofacial Surgery in Maryville, TN

NPI Status: Active since July 07, 2005

Contact Information

1505 E LAMAR ALEXANDER PKWY
MARYVILLE, TN
ZIP 37804
Phone: (865) 983-8630
Fax: (865) 983-3616

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 40
Dentist
Oral and Maxillofacial Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About MARK WIDLOSKI

This page provides the complete NPI Profile along with additional information for Mark Widloski, a provider established in Maryville, Tennessee with a medical specialization in Dentist, focusing in oral and maxillofacial surgery and more than 40 years of experience. He graduated from Medical College Of Wisconsin in 1986. The healthcare provider is registered in the NPI registry with number 1285631135 assigned on July 2005. The practitioner's primary taxonomy code is 1223S0112X with license number DS4711 (TN). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI: 1285631135
Provider Name: MARK M. WIDLOSKI DDS
Gender: Male
Entity Type: Individual
Location Address: 1505 E LAMAR ALEXANDER PKWY MARYVILLE, TN 37804
Location Phone: (865) 983-8630
Location Fax: (865) 983-3616
Mailing Address: 1505 E LAMAR ALEXANDER PKWY MARYVILLE, TN 37804
Mailing Phone: (865) 983-8630
Mailing Fax: (865) 983-3616
Medical School Name: MEDICAL COLLEGE OF WISCONSIN
Graduation Year: 1986
Is Sole Proprietor?: No
Enumeration Date: 07-07-2005
Last Update Date: 10-10-2011
Code Navigator

A dentist like Mark Widloski is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Dentist Oral and Maxillofacial Surgery
Taxonomy Code: 1223S0112X
Type: Dental Providers
License No.: DS4711
License State: TN
Taxonomy Description: An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Arkansas Health & Wellness

Choice Bronze HSA (QualChoice) - POS
Complete Gold - PPO
Complete Gold + Vision + Adult Dental - PPO
Connected Silver - PPO
Connected Silver (QualChoice) - POS
Connected Silver (QualChoice) + Vision + Adult Dental - POS
Connected Silver (QualChoiceLife) - PPO
Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
Connected Silver + Vision + Adult Dental - PPO
Elite Bronze - PPO
Elite Bronze + Vision + Adult Dental - PPO
Elite Gold (QualChoice) - POS
Elite Gold (QualChoice) + Vision + Adult Dental - POS
Elite Gold (QualChoiceLife) - PPO
Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
Everyday Bronze - PPO
Everyday Bronze + Vision + Adult Dental - PPO
Standard Expanded Bronze - PPO
Standard Expanded Bronze (QualChoice) - POS
Standard Expanded Bronze + Vision + Adult Dental - PPO

Ambetter from Home State Health

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Complete Silver - EPO
Complete Silver + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO
Standard Expanded Bronze - EPO
Standard Expanded Bronze + Vision + Adult Dental - EPO
Standard Gold - EPO
Standard Gold + Vision + Adult Dental - EPO
Standard Silver - EPO
Standard Silver + Vision + Adult Dental - EPO

Ambetter from Magnolia Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Everyday Gold - HMO
Everyday Gold + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO
Standard Gold - HMO
Standard Gold + Vision + Adult Dental - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Ambetter of Alabama

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Enhanced Diabetes Care Silver with $0 Drug Options - EPO
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO
Standard Expanded Bronze - EPO
Standard Expanded Bronze + Vision + Adult Dental - EPO
Standard Gold - EPO
Standard Gold + Vision + Adult Dental - EPO
Standard Silver - EPO
Standard Silver + Vision + Adult Dental - EPO

Ambetter of North Carolina

Clear Silver with $0 Insulin Options - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Gold with Atrium Health - HMO
Complete Gold with Atrium Health + Vision + Adult Dental - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Elite Bronze with Atrium Health - HMO
Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Everyday Bronze with Atrium Health - HMO
Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
Focused Silver with Atrium Health - HMO
Focused Silver with Atrium Health + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO
Standard Expanded Bronze with Atrium Health - HMO

Ambetter of Tennessee

Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Enhanced Diabetes Care Silver with $0 Drug Options - EPO
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO
Standard Expanded Bronze - EPO
Standard Expanded Bronze + Vision + Adult Dental - EPO
Standard Gold - EPO
Standard Gold + Vision + Adult Dental - EPO
Standard Silver - EPO
Standard Silver + Vision + Adult Dental - EPO

Anthem Blue Cross and Blue Shield

Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway 8500 for HSA - HMO
Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Catastrophic Essential (+ Incentives) - HMO
Anthem Catastrophic Pathway (+ Incentives) - EPO
Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO

Blue Cross and Blue Shield of Alabama

Blue HSA Bronze - PPO
Blue Protect - PPO
Blue Saver Bronze - PPO
Blue Standardized Statewide Silver EPO - EPO
Blue Statewide Silver EPO - EPO
Blue Value Gold - PPO
Blue Value Silver - PPO
Blue Access Gold for Business - PPO
Blue Choice Platinum for Business - PPO
Blue HSA Silver for Business - PPO
Blue Saver Bronze for Business - PPO
Blue Saver Gold for Business - PPO
Blue Secure Gold for Business - PPO
Blue Secure Silver for Business - PPO

Blue Cross and Blue Shield of Montana

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Oklahoma

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Texas

BlueCare Dental 1D - PPO
BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO

BlueCross BlueShield of Tennessee

BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO

Florida Combined Life

BlueDental Copayment Q - PPO
BlueDental Copayment QF - PPO

Guardian

Guardian Basics for Families and Individuals - PPO
Guardian Essentials for Families and Individuals - PPO
Guardian Preventive Plus for Families and Individuals - PPO
Guardian Select for Families and Individuals - PPO

Humana

Humana Dental Smart Choice - PPO
Humana Dental Smart Choice - Basic - PPO
Humana Dental Smart Choice - High - PPO
Humana Dental Smart Choice - Lite - PPO
Humana Dental Smart Choice - Low - PPO

UnitedHealthcare

UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
UHC Bronze Essential (No Referrals) - EPO
UHC Bronze Standard (No Referrals) - EPO
UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
UHC Gold Standard (No Referrals) - EPO
UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
UHC Silver Standard (No Referrals) - EPO
Lone Star - Smile Now - PPO
Smile Now Arizona - No Waiting Period PPO - PPO
Smile Now Michigan - No Waiting Period PPO - PPO
Smile Now Ohio - No Waiting Period PPO - PPO
Smile Now Texas- No Waiting Period Plan - PPO
Smile Now Utah - No Waiting Period PPO - PPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
3225440	MEDICAID (05)	TN
T74436	MEDICARE UPIN (02)	TN
3225440	MEDICARE ID-TYPE UNSPECIFIED (04)	TN

Medicare Participation & PECOS Enrollment Status

Mark Widloski is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Mark Widloski is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 4981733391
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20100525000036
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

New patient office or other outpatient visit, 15-29 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.38 for a new patient copayment and $16.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 37804 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $81.53
Minimum New Patient Price $52.64
Maximum New Patient Price $160.89

Average New Patient Copayment $20.38
Minimum New Patient Copayment $13.16
Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $66.01
Minimum Established Patient Price $16.72
Maximum Established Patient Price $131.41

Average Established Patient Copayment $16.5
Minimum Established Patient Copayment $4.18
Maximum Established Patient Copayment $32.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1285631135, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 16 → 1 + 6

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 6 → 12 → 3 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 6 + 5 + 1 + 2 + 3 + 2 + 1 + 6 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1285631135.