DR. MARK A BRUNNER DDS
NPI 1891714135
Dentist - Periodontics in Jenison, MI

Q: What is Mark Brunner's NPI number?

The NPI number for Mark Brunner is 1891714135. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Q: What is Mark Brunner's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Mark Brunner was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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 18, 2006PECOS Enrolled

2064 BALDWIN ST STE A, JENISON, MI 49428(616) 264-3815(404) 352-9381 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 14, 2025, Oct 19, 2017 (2 updates tracked since 2017).

On this page

About Dr. Mark A Brunner Dds NPPES

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

DR. MARK A BRUNNER DDS (NPI 1891714135) is an individual periodontics provider in Jenison, Michigan, licensed in Georgia (12499) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mishawaka.

NPPES Registry Identity

NPI1891714135

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. MARK A BRUNNERCredential: DDS

Location Address2064 BALDWIN ST STE AJenison, MI 49428-8773

Mailing Address2064 Baldwin St Ste AJenison, MI 49428-8773 · (404) 352-3123 · Fax (404) 352-9381

Phone(616) 264-3815

Fax(404) 352-9381

Sole ProprietorNo

Enumeration DateJuly 18, 2006

Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1891714135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in GA · 12499

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

2064 BALDWIN ST STE A, Jenison, MI 49428

Open in Google Maps ↗

Secondary Practice Location 1

Location 1518 Lincolnway WMishawaka, IN 46544-1807 · Phone (574) 255-5630

Accepted Insurance

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

Dr. Mark A Brunner 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 49428 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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 2

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

DR. DALEEN SIHEIM HAMMOUD DDS

Dentist

2064 BALDWIN ST STE A
JENISON, MI 49428

Ottawa County (616) 457-2299

MS. MARLA KETTY FLEMING DMD

Dentist

2064 BALDWIN ST STE A
JENISON, MI 49428

Ottawa County (616) 229-0269

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 Brunner's NPI number?

The NPI number for Mark Brunner is 1891714135. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is Mark Brunner located?

Mark Brunner practices at 2064 Baldwin St Ste A, Jenison, MI 49428. The listed phone number is (616) 264-3815.

What is Mark Brunner's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Mark Brunner enrolled in Medicare?

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

What insurance does Mark Brunner accept?

Health plans from BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Mark Brunner 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 Brunner was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.