Michael Francis Edziak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D22148 Issued in CA

Practice address

150 Hospital Dr.
Vallejo, CA 94589

Phone

(707) 642-4403

Fax

(707) 642-0844

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael F Edziak, DDS

  • General Practice Dentistry
  • Vallejo, CA
  • NPI 1912117326
  NPD (past) Authorized official

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1063629236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 HOSPITAL DR STE 204",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892500",
            "telephone_number": "707-642-4403",
            "fax_number": "707-642-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HOSPITAL DR.",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94589",
            "telephone_number": "707-642-4403",
            "fax_number": "707-642-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDZIAK",
        "first_name": "MICHAEL",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D22148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eden Castillo Edora, D.M.D.
• Eduardo M Abdala, M.D. Inc
• Angela Edwards
• James L. Edwards, MD
• Maurice Edwards
• Tracy Eidson, N.P.
• Christiane Natascha Eisele, M.D.
• Elder Dental Corp
• Sandy Elgendy, PHARM D
• Nicole Marie Elias

• General Practice Dentistry in Vallejo, CA
• Providers in Vallejo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.