MARK DWAIN FENTON (OD) – Optometrist, NPI 1144280934

MARK DWAIN FENTON (OD) is a healthcare provider. based in Wilmington, Ohio. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. 4191 (OH). The NPI Number for MARK DWAIN FENTON (OD) is 1144280934

Main info

Male
Sole Proprietor
Name
MARK DWAIN FENTON (OD)
NPI
1144280934
Phone
(937) 383-2410
Address
375 INDIAN RIPPLE ROAD
Enumeration Date
24 March 2006
Last Update Date
13 February 2012
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MARK DWAIN FENTON (OD)

  • 375 INDIAN RIPPLE ROAD

    WILMINGTON, OH 45177

    Phone: (937) 383-2410

    Type: Mailing

  • Beechmont Avenue, Linwood, Cincinnati, Hamilton County, Ohio, 45226, United States

    CINCINNATI, OH 452554708

    Phone: (513) 474-0122

    Fax: (513) 474-1376

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-04-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120402000553IOptometryOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45177)

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Reviews

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Frequently asked questions

What federal number belongs to MARK DWAIN FENTON (OD)?
The federal identifier for MARK DWAIN FENTON (OD) is NPI 1144280934.
Is MARK DWAIN FENTON (OD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does MARK DWAIN FENTON (OD) work in?
You can think of MARK DWAIN FENTON (OD) as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Does MARK DWAIN FENTON (OD) practice in Ohio?
You will see Wilmington, Ohio on file for MARK DWAIN FENTON (OD) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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