Thaddeus G. Zawislak Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS026933L Issued in PA

Practice address

161 E Bissell Ave
Oil City, PA 16301-1972

Phone

(814) 677-1341

Fax

(814) 676-6627

NPI assigned

Dec 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1063499986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 E BISSELL AVE",
            "city": "OIL CITY",
            "state": "PA",
            "postal_code": "163011972",
            "telephone_number": "814-677-1341",
            "fax_number": "814-676-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E BISSELL AVE",
            "city": "OIL CITY",
            "state": "PA",
            "postal_code": "163011972",
            "telephone_number": "814-677-1341",
            "fax_number": "814-676-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAWISLAK",
        "first_name": "THADDEUS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026933L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011797170002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Yarnell, MS
• Donna Yates, MS
• Paula J Young
• Sarah Young, MSW
• Angie Marie Zaffuto
• Kristie Ziegler, LPC

• General Practice Dentistry in Oil City, PA
• Providers in Oil City, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.