David K Mazgaj, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

042969 Issued in NY

Practice address

1616 Abbott Rd
Lackawanna, NY 14218-2937

Phone

(716) 823-1770

Fax

(716) 332-4329

NPI assigned

Dec 17, 2007

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 29, 2015 through Dec 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1265615983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 ABBOTT RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142182937",
            "telephone_number": "716-823-1770",
            "fax_number": "716-332-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 ABBOTT RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142182937",
            "telephone_number": "716-823-1770",
            "fax_number": "716-332-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZGAJ",
        "first_name": "DAVID",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Rita Andaya MD PLLC
• Marcos Marques
• Jocelyn M Massaro, PT, DPT
• Darlene Ann Matesic, OTR/L
• James Harvey Matthews, MD
• Linda A McCartan, LMHC
• Cathy McCool
• Lindsay B Messore, SLP
• Marie Terese Meyer, MA CCC L-SLP
• Michael J Pietrusik DPM

• General Practice Dentistry in Lackawanna, NY
• Providers in Lackawanna, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.