MARK O WALLER D.D.S.
NPI 1679670046
Dentist - General Practice in Sussex, WI

Q: What is Mark Waller's NPI number?

The NPI number for Mark Waller is 1679670046. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Q: What is Mark Waller's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Mark Waller was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since September 20, 2006PECOS Enrolled

N63 W23401 MAIN ST, SUSSEX, WI 53089(262) 246-6806(262) 246-6892 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mark O Waller D.d.s. NPPES

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

MARK O WALLER D.D.S. (NPI 1679670046) is an individual general practice provider in Sussex, Wisconsin, licensed in Wisconsin (3012) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679670046

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameMARK O WALLERCredential: D.D.S.

Location AddressN63 W23401 MAIN STSussex, WI 53089-0229

Mailing AddressPo Box 229Sussex, WI 53089-0229 · (262) 246-6806 · Fax (262) 246-6892

Phone(262) 246-6806

Fax(262) 246-6892

Sole ProprietorYes

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1679670046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WI · 3012

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.

N63 W23401 MAIN ST, Sussex, WI 53089

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Other Identifiers 1

Other799832United Concordia

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.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)

Mark O Waller 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 53089 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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

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

KAREN M. BOETTCHER, D.D.S.,S.C.

Dentist (General Practice)

N63 W23401 MAIN ST
SUSSEX, WI 53089

Waukesha County (262) 246-6806

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 Waller's NPI number?

The NPI number for Mark Waller is 1679670046. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Mark Waller located?

Mark Waller practices at N63 W23401 Main St, Sussex, WI 53089. The listed phone number is (262) 246-6806.

What is Mark Waller's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mark Waller enrolled in Medicare?

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

What insurance does Mark Waller accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Mark Waller 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 Waller was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.