Mark A. Paciorek, DDS, MS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

045777 Issued in NY

Practice address

5099 West Genesee Street
Camillus, NY 13031

Phone

(315) 487-3335

Fax

(315) 487-5865

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Tag Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Camillus, NY
  • NPI 1316725096
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1033298559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4981 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312313",
            "telephone_number": "315-487-3335",
            "fax_number": "315-487-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5099 WEST GENESEE STREET",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "13031",
            "telephone_number": "315-487-3335",
            "fax_number": "315-487-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIOREK",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "045777",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nurturing Connections Marriage and Family Therapy, PLLC
• Chelsea O'Connor, NP
• Kathleen M O'Connor, NP
• Ivan Y Olesh
• Kimberly Lynn Olrich, FNP
• Stefanie Pack-Campbell, LPN
• Jessica Lynn Pagan, MS, LMHC, NCC
• David Thurber Page, MD
• Angela Marie Pagorek, RPH
• Ana Maria Paniagua, LCSW

• Dentist in Camillus, NY
• Providers in Camillus, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.