DR. MARK KEYAN TADRISSI D.D.S.
NPI 1619907508
Dentist - Endodontics in Charlotte, NC

Q: What is Mark Tadrissi's NPI number?

The NPI number for Mark Tadrissi is 1619907508. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Q: What is Mark Tadrissi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Q: When was this NPI record last updated?

The NPPES record for Mark Tadrissi was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 July 04, 2006PECOS Enrolled

14135 BALNTYN CORP PL STE 215, CHARLOTTE, NC 28277(704) 541-7017 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Dr. Mark Keyan Tadrissi D.d.s. NPPES

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

DR. MARK KEYAN TADRISSI D.D.S. (NPI 1619907508) is an individual endodontics provider in Charlotte, North Carolina, licensed in North Carolina (9377) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619907508

Entity TypeIndividualMale

Primary Taxonomy1223E0200X

Provider Legal NameDR. MARK KEYAN TADRISSICredential: D.D.S.

Location Address14135 BALNTYN CORP PL STE 215Charlotte, NC 28277-4452

Mailing Address14135 Balntyn Corp Pl Ste 215Charlotte, NC 28277-4452 · (704) 541-7017

Phone(704) 541-7017

Sole ProprietorNo

Enumeration DateJuly 4, 2006

Last NPPES UpdateJune 23, 2026

NPPES CertifiedJune 23, 2026

✔ NPI 1619907508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

License✔ Licensed in NC · 9377

Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

14135 BALNTYN CORP PL STE 215, Charlotte, NC 28277

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana.Insurance ›

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 Keyan Tadrissi D.d.s. 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 28277 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

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 Tadrissi's NPI number?

The NPI number for Mark Tadrissi is 1619907508. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Mark Tadrissi located?

Mark Tadrissi practices at 14135 Balntyn Corp Pl Ste 215, Charlotte, NC 28277. The listed phone number is (704) 541-7017.

What is Mark Tadrissi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Mark Tadrissi enrolled in Medicare?

Yes. Mark Tadrissi is registered in the Medicare PECOS enrollment system.

What insurance does Mark Tadrissi accept?

Health plans from Humana list Mark Tadrissi 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 Tadrissi was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.