DR. MARK CARLYLE WOODBURY DMD
NPI 1619663051
Dentist - Pediatric Dentistry in Fountain, CO

Active since April 17, 2023PECOS Enrolled
6620 CAMDEN BLVD, FOUNTAIN, CO 80817(719) 631-6136 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Mark Carlyle Woodbury Dmd NPPES

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

DR. MARK CARLYLE WOODBURY DMD (NPI 1619663051) is an individual pediatric dentistry provider in Fountain, Colorado, licensed in Colorado (DEN.00206270) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619663051
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. MARK CARLYLE WOODBURYCredential: DMD
Location Address6620 CAMDEN BLVDFountain, CO 80817-2505
Mailing Address8276 Mosby WayColorado Springs, CO 80908-5692 · (801) 712-7403
Sole ProprietorNo
Enumeration DateApril 17, 2023
Last NPPES UpdateAugust 13, 2025
NPPES CertifiedAugust 13, 2025
NPI 1619663051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License Licensed in CO · DEN.00206270
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.

6620 CAMDEN BLVD, Fountain, CO 80817

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Mark Carlyle Woodbury Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80817 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 (Pediatric Dentistry)
6620 CAMDEN BLVD
FOUNTAIN, CO 80817
Dentist (Orthodontics and Dentofacial Orthopedics)
6620 CAMDEN BLVD
FOUNTAIN, CO 80817
Dentist (Orthodontics and Dentofacial Orthopedics)
6620 CAMDEN BLVD
FOUNTAIN, CO 80817
Dentist (Pediatric Dentistry)
6620 CAMDEN BLVD
FOUNTAIN, CO 80817

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619663051, enumerated as an "individual" on April 17, 2023.

The provider is located at 6620 CAMDEN BLVD FOUNTAIN, CO 80817 and the phone number is (719) 631-6136.

Dentist with taxonomy code 1223P0221X and a focus in Pediatric Dentistry.