Individual provider Active NPI

Bruce Stanley Zelazek, DDS

  • General Practice Dentistry
  • Lake Worth, FL
National Provider Identifier
1053433144
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10210 Issued in FL
Practice address
7689 Lake Worth Rd
Lake Worth, FL 33467-2534
Phone
(561) 966-5577
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10210 FL Primary

Addresses

Primary practice location

7689 Lake Worth Rd
Lake Worth, FL 33467-2534

Mailing address

7689 Lake Worth Rd
Lake Worth, FL 33467-2534
Phone (561) 966-5577

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
10210FLMDSurgical Assistant

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053433144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7689 LAKE WORTH RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672534",
            "telephone_number": "561-966-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7689 LAKE WORTH RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672534",
            "telephone_number": "561-966-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAZEK",
        "first_name": "BRUCE",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "10210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.