Individual provider Active NPI

Jaroslaw Cegielski, D.M.D.

  • Dentist
  • Port Saint Lucie, FL
National Provider Identifier
1215046446
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN16148 Issued in FL
Practice address
150 SW Chamber CT
Suite 201
Port Saint Lucie, FL 34986-3413
Phone
(772) 336-8253
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN16148 FL Primary

Addresses

Primary practice location

150 SW Chamber CT
Suite 201
Port Saint Lucie, FL 34986-3413

Mailing address

150 SW Chamber CT
Suite 201
Port Saint Lucie, FL 34986-3413
Phone (772) 336-8253

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

LicenseStateTypeSpecialty
DN16148FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentihealth LLC PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1215046446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SW CHAMBER CT",
            "address_2": "SUITE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863413",
            "telephone_number": "772-336-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SW CHAMBER CT",
            "address_2": "SUITE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863413",
            "telephone_number": "772-336-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEGIELSKI",
        "first_name": "JAROSLAW",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.