Benjamin Leo Zarzecki, D.D.S.
Individual provider Active NPI Dentist · Evart, MI
NPI 1124214523 · NPPES record last updated Oct 7, 2020
Key facts
- NPI
- 1124214523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901019683 (MI)
- Practice address
- 120 N Pine St
Evart, MI 49631-5120 - Phone
- (231) 734-5621
- Fax
- (231) 734-5851
- NPI assigned
- Sep 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151023001666 | MI | Order and Referring Only - Dentist |
5799094298 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901019683 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benjamin L. Zarzecki DDS PLLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901019683 | MI | Yes |
Addresses
Primary practice location
120 N Pine St
Evart, MI 49631-5120
Mailing address
PO Box 687
Evart, MI 49631-0687
Phone (231) 734-5621
Other providers in Evart, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.