Scott D. Prusinski, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008815 Issued in IN

Practice address

1641 Main St
Elwood, IN 46036-2025

Phone

(765) 552-6542

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in IN

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306060546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 MAIN ST",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460362025",
            "telephone_number": "765-552-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 MAIN ST",
            "city": "ELWOOD",
            "state": "IN",
            "postal_code": "460362025",
            "telephone_number": "765-552-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSINSKI",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Naylor, LCSW
• Mary Pence
• Amanda A Petker, OT
• Pipe Creek Township (Pipe Creek Fire Dept)
• Jean Marie Pison, RPH
• Vera A Psalmonds-Hunt, B.A.
• Putnam County Hospital (Elwood Health and Living)
• Mariah Ramer, LMHC
• Dale E Richmond, BA
• Carlisa Robinson, BCBA

• General Practice Dentistry in Elwood, IN
• Providers in Elwood, IN by specialty
• General Practice Dentistry in Indiana

• 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.