Christopher R Pesicek, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20680 Issued in OH

Practice address

1457 Burbank Rd
Wooster, OH 44691-2325

Phone

(330) 264-8688

NPI assigned

May 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275755050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1457 BURBANK RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912325",
            "telephone_number": "330-264-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 BURBANK RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912325",
            "telephone_number": "330-264-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESICEK",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Perry Dobson
• Pearce Joshua Perry
• Rico D Person
• Personal Helpers Home Care LLC
• Personal Touch Home Care of Ohio, Inc
• Stephen Scott Pesicek, D.D.S.
• Andrew Michael Peters, LPN
• Dawn E Peters, MA, LPCC
• Nichole Lee Peters, LSW
• Allison Peterson, LISW

• General Practice Dentistry in Wooster, OH
• Providers in Wooster, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.