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

Mark M. Widloski, DDS

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1285631135

Mark M. Widloski, DDS is a Maxillofacial Surgery in Maryville, Tennessee. Graduated from Medical College of Wisconsin in 1986, 40 years ago. Practices with East Tennessee Oral and Maxillofacial Surgery, PC, a 5-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
40
Trained at
Medical College of Wisconsin
Licensed in
TN
In the registry since
2005
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1505 E Lamar Alexander Pkwy
Maryville, TN 37804-5131
Phone: (865) 983-8630
Fax: (865) 983-3616
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DS4711 (TN)

Record details

NPI number1285631135
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJuly 7, 2005
Last updated in NPPESOctober 10, 2011
Mailing address1505 E Lamar Alexander Pkwy, Maryville, TN 37804-5131

Medicare enrollment

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

Medicare specialtyMAXILLOFACIAL SURGERY
Also practisesORAL SURGERY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 1986 (40 years in practice)
Group practice East Tennessee Oral And Maxillofacial Surgery, Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Maryville