Pawel D Fotek DMD PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN18002 Issued in FL

Legal business name

PAWEL D FOTEK DMD PLLC

Doing business as

Prestige Periodontal and Implant Center

Practice address

11641 Kew Gardens Ave
Suite 209
Palm Beach Gardens, FL 33410-2763

Phone

(561) 693-3236

NPI assigned

Mar 13, 2017

Last updated

Mar 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pawel D FotekNPI 1336331693

Title

Owner

Phone

(561) 693-3236

Specialties & licenses 1

Addresses

Other names 1

• Prestige Periodontal and Implant Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pawel D Fotek, DMD

  • Periodontics
  • Palm Beach Gardens, FL
  • NPI 1336331693
  NPD (past) Authorized official

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1063953875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11641 KEW GARDENS AVE",
            "address_2": "SUITE 209",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102763",
            "telephone_number": "561-693-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11641 KEW GARDENS AVE",
            "address_2": "SUITE 209",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102763",
            "telephone_number": "561-693-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWEL D FOTEK DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "FOTEK",
        "authorized_official_first_name": "PAWEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-693-3236"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN18002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Periodontal and Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal L Paul, LMT
• John Stephen Paul, O.D.
• Josephine Paul
• Marie Lucknie Paul
• Numane Paul
• Triton Payne
• Cameron Weldon Pazos
• PB Gardens Drugs LLC (Gardens Drugs)
• PB Gardens Drugs LLC (Gardens Pharmacy)
• PBC Foot Ankle Center LLC

• Periodontics in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Periodontics in Florida

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