Active NPI
John A Pizarek, D.M.D.
- Periodontics
- Oak Harbor, WA
National Provider Identifier
1093182271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 019.030194
- Practice address
- 3475 N Saratoga St
Oak Harbor, WA 98278-4927 - Phone
- (360) 257-5945
- NPI assigned
- Aug 24, 2015
- Last updated
- Sep 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| R731 | MN | MD | Dentist |
| 019.030194 | IL | MD | Periodontist |
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.