Individual provider Active NPI

Douglas E Kowalczyk, D.D.S.

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1053458778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16839 Issued in OH
Practice address
6481 Nicholas Dr
Columbus, OH 43235-5204
Phone
(614) 799-9500
NPI assigned
Jan 31, 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 16839 OH Primary

Addresses

Primary practice location

6481 Nicholas Dr
Columbus, OH 43235-5204

Mailing address

8609 Lazelle Commons Dr
Lewis Center, OH 43035-8731
Phone (614) 209-6152

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
16839OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Linworth Family Dental, DRS. Kowalczyk, Glasgow, & Soungpradith, Inc. General Practice 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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053458778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 LAZELLE COMMONS DR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430358731",
            "telephone_number": "614-209-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6481 NICHOLAS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432355204",
            "telephone_number": "614-799-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "DOUGLAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

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.