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MARK ANDREW BRODHAGEN DDS
NPI 1760468136
Dentist - General Practice in Green Bay, WI

Active since December 19, 2005PECOS Enrolled
1052 BEL AIRE CT, GREEN BAY, WI 54304(920) 499-2121(920) 499-7644 Get Directions Write a Review

NPPES record last updated: April 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 13, 2026, Sep 4, 2018, Nov 16, 2016 (3 updates tracked since 2016).

About Mark Andrew Brodhagen Dds NPPES

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

MARK ANDREW BRODHAGEN DDS (NPI 1760468136) is an individual general practice provider in Green Bay, Wisconsin, licensed in Wisconsin (1338G) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760468136
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameMARK ANDREW BRODHAGENCredential: DDS
Location Address1052 BEL AIRE CTGreen Bay, WI 54304-5015
Mailing Address1052 Bel Aire CtGreen Bay, WI 54304-5015 · (920) 499-2121 · Fax (920) 499-7644
Phone(920) 499-2121
Fax(920) 499-7644
Sole ProprietorYes
Enumeration DateDecember 19, 2005
Last NPPES UpdateApril 13, 20263 updates tracked since enumeration
NPPES CertifiedApril 13, 2026
✔ NPI 1760468136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WI · 1338G
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License 1338G (WI)
1052 BEL AIRE CT, Green Bay, WI 54304
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Wisconsin, Inc., Guardian, Humana and more.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 Andrew Brodhagen Dds 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 54304 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 5

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

BAY PARK SMILES LLC
Dentist (General Practice)
1052 BEL AIRE CT
GREEN BAY, WI 54304
Brown County (920) 499-2121
SLEEP HEALTH WISCONSIN LLC
Durable Medical Equipment & Medical Supplies
1052 BEL AIRE CT
GREEN BAY, WI 54304
Brown County (920) 499-2121
MICHAEL A. BROSSMAN DMD
Dentist
1052 BEL AIRE CT
GREEN BAY, WI 54304
Brown County (920) 499-2121
DR. ROBERT JOHN GOELZ D.D.S.
Dentist (General Practice)
1052 BEL AIRE CT
GREEN BAY, WI 54304
Brown County (920) 499-8711
ANNE MARIE CZYZ-KLEMENS DMD
Dentist (General Practice)
1052 BEL AIRE CT
GREEN BAY, WI 54304
Brown County (920) 499-2121

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 Brodhagen's NPI number?

The NPI number for Mark Brodhagen is 1760468136. It was assigned to this individual provider in the NPPES registry on December 19, 2005.

Where is Mark Brodhagen located?

Mark Brodhagen practices at 1052 Bel Aire Ct, Green Bay, WI 54304. The listed phone number is (920) 499-2121.

What is Mark Brodhagen's specialty?

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

Is Mark Brodhagen enrolled in Medicare?

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

What insurance does Mark Brodhagen accept?

Health plans from Delta Dental of Wisconsin, Inc., Guardian, Humana, Network Health and Security Health Plan list Mark Brodhagen 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 Brodhagen was last updated on April 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.