Zenon Paul Kossak, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901020635 Issued in MI

Practice address

300 E Long Lake Rd Ste 290
Bloomfield Hills, MI 48304-2378

Phone

(248) 203-2330

NPI assigned

Jun 22, 2012

Last updated

Jun 18, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• New Image Maxillofacial LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Melbourne, FL
  • NPI 1194767707
  Medicare reassignment NPD
• Great Expressions Dental Centers P C

  • Dentist
  • Bloomfield Hills, MI
  • NPI 1124164926
  NPD (past)

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1306109475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E LONG LAKE RD STE 290",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042378",
            "telephone_number": "248-203-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E LONG LAKE RD STE 290",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042378",
            "telephone_number": "248-203-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSSAK",
        "first_name": "ZENON",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN23273",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901020635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Kolton, PH.D.
• Jordan Anne Kondrat, PT, DPT
• Patricia A Kondratenko, D.O.
• Marie Eileen Kopmeyer, M.P.T
• Erin Nicole Koppelman, N.P.
• Shirin Koudsi
• Michael Kozlowski, D.C.
• Jordan Kraft, DPT
• Jordan Marie Kramer
• Susan Krawczyk, M.A., CCC-SLP

• Oral and Maxillofacial Surgery (Dentist) in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.