Mark Waller, D.D.S.
NPI 1679670046 · General Practice Dentistry · Sussex, WI
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mark Waller, D.D.S. is a General Practice Dentistry provider in Sussex, WI (NPI 1679670046).
Provider details
- NPI number
- 1679670046
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 3012 (WI)
Specialties & taxonomies
Dental Providers
Profile Score
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
Mailing address
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2007-07-08
Frequently asked questions
- What is Mark Waller's NPI number?
- Mark Waller's National Provider Identifier (NPI) is 1679670046, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Waller's specialty?
- Mark Waller is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Mark Waller located?
- Mark Waller's practice location on file with NPPES is N63 W23401 Main St, Sussex, WI 53089-0229.
- What is Mark Waller's phone number?
- The practice phone number listed in the NPPES registry for Mark Waller is (262) 246-6806.
- Does Mark Waller accept Medicare?
- Mark Waller is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mark Waller's NPI active?
- Yes — Mark Waller's NPI (1679670046) is active in the NPPES registry as of the last update on 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.