Thomas Steven Rudzinski, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

11119 Issued in MI

Practice address

140 River St
Elk Rapids, MI 48629

Phone

(231) 264-8176

Fax

(231) 264-8173

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 MI

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

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114090578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 RIVER ST",
            "address_2": "PO BOX 157",
            "city": "ELK RAPIDS",
            "state": "MI",
            "postal_code": "49629",
            "telephone_number": "231-264-8176",
            "fax_number": "231-264-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 RIVER ST",
            "city": "ELK RAPIDS",
            "state": "MI",
            "postal_code": "48629",
            "telephone_number": "231-264-8176",
            "fax_number": "231-264-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDZINSKI",
        "first_name": "THOMAS",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "11119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven M Pray, D.O.
• Nicholas Kurz Pryde, MD
• Matthew Douglas Reckinger
• River Pharmacy Inc (River Pharmacy)
• Shelly Rozanski
• Jennifer A Shockley, M.D.
• Maureen Reynolds Street, MD
• Toivoa Counseling
• Kathleen Van Pelt, LMSW
• Deirdre A Wickham, DO

• Dentist in Elk Rapids, MI
• Providers in Elk Rapids, MI by specialty
• Dentist in Michigan

• 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.