Active NPI
Jason Wesley Zitofsky, D.D.S
- Dentist
- Severna Park, MD
National Provider Identifier
1407022031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14085
- Practice address
- 22 Truck House Rd
Suite 3
Severna Park, MD 21146-2728 - Phone
- (410) 647-4269
- Fax
- (410) 544-5910
- NPI assigned
- May 4, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14085 | MD | Primary |
Addresses
Primary practice location
22 Truck House Rd
Suite 3
Severna Park, MD 21146-2728
Mailing address
22 Truck House Rd
Suite 3
Severna Park, MD 21146-2728
Phone (410) 647-4269
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14085 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cheskis, Hooper, Schatz, Russell & Assc., LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Severna Park, MD
- NPI 1629082938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485993600000",
"number": "1407022031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 TRUCK HOUSE RD",
"address_2": "SUITE 3",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211462728",
"telephone_number": "410-647-4269",
"fax_number": "410-544-5910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 TRUCK HOUSE RD",
"address_2": "SUITE 3",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211462728",
"telephone_number": "410-647-4269",
"fax_number": "410-544-5910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZITOFSKY",
"first_name": "JASON",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-04",
"last_updated": "2017-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "14085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.