Individual provider Active NPI

Pawel L Dyczek, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1013175355
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
046439-1 Issued in NY
Practice address
147 Driggs Ave
Brooklyn, NY 11222-4213
Phone
(718) 389-8200
NPI assigned
May 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 046439-1 NY Primary

Addresses

Primary practice location

147 Driggs Ave
Brooklyn, NY 11222-4213

Mailing address

147 Driggs Ave
Brooklyn, NY 11222-4213
Phone (718) 389-8200

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
046439-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dental Studio P.C. Past Accepting new patients

Organizations & group practices 1

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": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1013175355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 DRIGGS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112224213",
            "telephone_number": "718-389-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 DRIGGS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112224213",
            "telephone_number": "718-389-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCZEK",
        "first_name": "PAWEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "046439-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.