Individual provider Active NPI

Ann Setkowicz, D.D.S.

  • General Practice Dentistry
  • Clearwater, FL
National Provider Identifier
1306963202
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN12203 Issued in FL
Practice address
2555 Enterprise Rd
Suite 3
Clearwater, FL 33763-1160
Phone
(727) 796-9669
Fax
(727) 791-7668
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN12203 FL Primary

Addresses

Primary practice location

2555 Enterprise Rd
Suite 3
Clearwater, FL 33763-1160

Mailing address

PO Box 14325
Clearwater, FL 33766-4325

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150722004531 FL Order and Referring Only - DentistPractitioner - Dentist 7517270358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN12203FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306963202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14325",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337664325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 ENTERPRISE RD",
            "address_2": "SUITE 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631160",
            "telephone_number": "727-796-9669",
            "fax_number": "727-791-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETKOWICZ",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.