IndividualActiveAccepts Medicare
Mark Bortolussi, DDS
NPI 1639285752 · Dentist · Marshall, MI
Enrolled with Medicare as Order and Referring Only - Other (physician) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1639285752
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 2901016722 (MI)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs 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
213 East Michigan Ave
Marshall, MI 49068
Phone: (269) 781-1108
Fax: (269) 781-9164
Street-level locationGet directions
Mailing address
213 East Michigan Ave
Marshall, MI 49068
Registry dates
- Enumerated
- 2006-08-22
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.