Individual provider Active NPI

John Jamnik, D.D.S.

  • Dentist
  • Keego Harbor, MI
National Provider Identifier
1245248962
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13582 Issued in MI
Practice address
2711 Orchard Lake Rd
Keego Harbor, MI 48320-1446
Phone
(248) 682-0922
NPI assigned
Aug 5, 2006
Last updated
Dec 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13582 MI Primary

Addresses

Primary practice location

2711 Orchard Lake Rd
Keego Harbor, MI 48320-1446

Mailing address

5285 Iroquois CT
Clarkston, MI 48348-3013
Phone (248) 394-1853

Other identifiers 2

IdentifierTypeStateIssuer
85771OtherMIUNITED CONCORDIA
4068598MedicaidMI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
13582MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
John F Jamnik D.D.S.,P.C CurrentSince Aug 28, 2022 Accepting new patients
Orchard Lake Dental Care Dentist PastSince Mar 19, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1245248962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5285 IROQUOIS CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483013",
            "telephone_number": "248-394-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 ORCHARD LAKE RD",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201446",
            "telephone_number": "248-682-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMNIK",
        "first_name": "JOHN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "13582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "85771",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4068598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keego Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.