IndividualActive
Mark Willis, DMD
NPI 1114810991 · General Practice Dentistry · Peachtree City, GA
Mark Willis, DMD is a General Practice Dentistry provider in Peachtree City, GA (NPI 1114810991).
Provider details
- NPI number
- 1114810991
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- DN123776 (GA)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2513 Redwine Rd Ste C
Peachtree City, GA 30269-4420
Phone: (770) 362-5569
Street-level locationGet directions
Mailing address
1250 Rockaway Rd
Senoia, GA 30276-1315
Registry dates
- Enumerated
- 2025-05-31
- Last updated
- 2025-05-31
- Certified
- 2025-05-31
Frequently asked questions
- What is Mark Willis's NPI number?
- Mark Willis's National Provider Identifier (NPI) is 1114810991, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Willis's specialty?
- Mark Willis is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Mark Willis located?
- Mark Willis's practice location on file with NPPES is 2513 Redwine Rd Ste C, Peachtree City, GA 30269-4420.
- What is Mark Willis's phone number?
- The practice phone number listed in the NPPES registry for Mark Willis is (770) 362-5569.
- Is Mark Willis's NPI active?
- Yes — Mark Willis's NPI (1114810991) is active in the NPPES registry as of the last update on 2025-05-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.