Zenon John Kossak, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901009356 Issued in MI

Practice address

24 Fair Acres Dr
Grosse Pointe Farms, MI 48236-3102

Phone

(313) 590-4350

NPI assigned

May 17, 2006

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Summit Oral & Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Warren, MI
  • NPI 1811066129
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1073565164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FAIR ACRES DR",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363102",
            "telephone_number": "313-590-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FAIR ACRES DR",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363102",
            "telephone_number": "313-590-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSAK",
        "first_name": "ZENON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901009356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K. Capps Counseling PLLC
• Karakunnel Home Care Ventures LLC
• Collin Jacob Karcher, AT, ATC
• Mariya Kopyrina, MD
• Kossak Consulting LLC
• Carolyn Barnard Kruse, BSN RN
• Shad DJ Kuklewski, LPTA
• Mathew John Kulas, L.AC.
• Manolis Kyriacou, MD
• Ann Marie Lambie

• Oral and Maxillofacial Surgery (Dentist) in Grosse Pointe Farms, MI
• Providers in Grosse Pointe Farms, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.