Marcin Jasek, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

019029790 Issued in IL

Practice address

6417 E Riverside Blvd
Rockford, IL 61114-4421

Phone

(815) 282-5233

NPI assigned

Jun 11, 2014

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1164836748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 FOXFIRE PL",
            "city": "ROCKTON",
            "state": "IL",
            "postal_code": "610722993",
            "telephone_number": "815-742-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144421",
            "telephone_number": "815-282-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASEK",
        "first_name": "MARCIN",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Joy Janusevic, DPT
• Berenice Jaquez, LCSW
• Basil Eid Jaradah, M.D.
• Therese Jarvi, LCPC
• Andrzej M Jasek, MD
• Katarzyna Anna Jasinska, M.D.
• Jason Soriano, Psy.D., P.C.
• Bruce A Jasper, M.D.
• Javon Bea Hospital
• Javon Bea Hospital

• Dentist in Rockford, IL
• Providers in Rockford, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.