Individual provider Active NPI

John Michael Pasicznyk, D.D.S

  • Dentist
  • Bonita Springs, FL
National Provider Identifier
1003127564
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26020 Issued in FL
Practice address
26811 S Bay Dr Ste 200
Bonita Springs, FL 34134-4356
Phone
(330) 990-5055
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN26020 FL Primary

Addresses

Primary practice location

26811 S Bay Dr Ste 200
Bonita Springs, FL 34134-4356

Mailing address

26811 S Bay Dr Ste 200
Bonita Springs, FL 34134-4356
Phone (239) 946-1881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN26020FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Dental Center, PLLC Dentist CurrentSince Mar 26, 2023 Accepting new patients
JP Dental - Keystone LLC Current Accepting new patients
Flpl01, PLLC Dentist CurrentSince Mar 26, 2023 Accepting new patients
Northview Dental Dentist Past Accepting new patients
Goodwine Dental, LLC PastSince Aug 28, 2021 Accepting new patients

Locations

26811 S Bay Dr
Ste 200
Bonita Springs, FL 34134
Phone (239) 946-1881

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1003127564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26811 S BAY DR STE 200",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344356",
            "telephone_number": "239-946-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26811 S BAY DR STE 200",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344356",
            "telephone_number": "330-990-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASICZNYK",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.