Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mark Nissenbaum, DMDMDCFCDSAOMFS

Individual provider Oral & Maxillofacial Surgery (D.M.D.) · NPI 1902897184

Dr. Mark Nissenbaum, DMDMDCFCDSAOMFS is a Maxillofacial Surgery in Chestnut Hill, Massachusetts. Qualified in 1995, 31 years ago. Practices with Jeffrey C. Sacks DMD MS PC, a 3-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
31
Licensed in
MA
In the registry since
2005

Practice location Address checks out

200 Boylston St Ste 305
Chestnut Hill, MA 02467-2012
Phone: (617) 731-8888
Fax: (617) 731-3107
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 8460 (MA)

Record details

NPI number1902897184
Entity typeIndividual (Type 1)
GenderMale
Credentials DMDMDCFCDSAOMFS
Sole proprietorNo
NPI enumeratedNovember 4, 2005
Last updated in NPPESFebruary 27, 2014
Mailing address200 Boylston St, Suite 305, Chestnut Hill, MA 02467-2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Jeffrey C. Sacks Dmd Ms Pc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Chestnut Hill