Stanley Michael Maciejewski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS028686L Issued in PA

Practice address

2702 Zuck Road
Erie, PA 16506

Phone

(814) 833-3535

Fax

(814) 833-3492

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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 PA

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

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104972504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 ZUCK ROAD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16506",
            "telephone_number": "814-833-3535",
            "fax_number": "814-833-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 ZUCK ROAD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16506",
            "telephone_number": "814-833-3535",
            "fax_number": "814-833-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEJEWSKI",
        "first_name": "STANLEY",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS028686L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marion G Macaluso, CRNA
• Collin Macdonald, MD
• Caylea Kansas Mace, PA-C
• Michael George Machuga, DMD
• Ryan Matthew Maciak, D.O.
• Lorri W Macisaac, SLP
• Roman Mack
• Angela Mackay, PT, DPT
• Katie Elizabeth Mackenzie
• Michele M Mackenzie, CRNA

• General Practice Dentistry in Erie, PA
• Providers in Erie, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.