Individual provider Active NPI

John A Pizarek, D.M.D.

  • Periodontics
  • Oak Harbor, WA
National Provider Identifier
1093182271
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
019.030194 Issued in IL
Practice address
3475 N Saratoga St
Oak Harbor, WA 98278-4927
Phone
(360) 257-5945
NPI assigned
Aug 24, 2015
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X R731 MN
Dentist 122300000X 019.030194 IL
Periodontics 1223P0300X 019.030194 IL Primary

Addresses

Primary practice location

3475 N Saratoga St
Oak Harbor, WA 98278-4927

Mailing address

PSC 561 Box 2834
Fpo, AP 96310-0029
Phone (315) 255-8540

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
R731MNMDDentist
019.030194ILMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1093182271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 561 BOX 2834",
            "city": "FPO",
            "state": "AP",
            "postal_code": "963100029",
            "telephone_number": "315-255-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 N SARATOGA ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982784927",
            "telephone_number": "360-257-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIZAREK",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "R731",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030194",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.030194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.