Mark Kolozenski, DDS, Ms, PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021001669 Issued in IL

Legal business name

MARK KOLOZENSKI, DDS, MS, PC

Practice address

10083 W Lincoln Hwy
Frankfort, IL 60423-1272

Phone

(815) 201-1000

Fax

(815) 201-1111

NPI assigned

Jul 25, 2014

Organization subpart

No

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

Authorized official

Name

Mark A Kolozenski, DDS

Title

Dentist/Owner

Phone

(815) 201-1000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1215345939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10083 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231272",
            "telephone_number": "815-201-1000",
            "fax_number": "815-201-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10083 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231272",
            "telephone_number": "815-201-1000",
            "fax_number": "815-201-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK KOLOZENSKI, DDS, MS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "KOLOZENSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "815-201-1000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Frankfort, IL
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.