IndividualActiveAccepts Medicare
Mark Wiatt, DDS
NPI 1801889209 · Dentist · T Or C, NM
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1801889209
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- DD-2602 (NM)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
1960 N Date St
T Or C, NM 87901-3701
Phone: (505) 267-3088
Fax: (505) 267-1747
Street-level locationGet directions
Mailing address
255 Hwy 187
Hatch, NM 87937-0730
Registry dates
- Enumerated
- 2005-08-31
- Last updated
- 2007-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.