Adam William Mychak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS037298L Issued in PA

Practice address

1408 East Carson St
South Side Dental Pavilion
Pittsburgh, PA 15203

Phone

(412) 431-6631

Fax

(412) 431-6297

NPI assigned

Feb 26, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1417126228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 EAST CARSON ST",
            "address_2": "SOUTH SIDE DENTAL PAVILION",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15203",
            "telephone_number": "412-431-6631",
            "fax_number": "412-431-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 EAST CARSON ST",
            "address_2": "SOUTH SIDE DENTAL PAVILION",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15203",
            "telephone_number": "412-431-6631",
            "fax_number": "412-431-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYCHAK",
        "first_name": "ADAM",
        "middle_name": "WILLIAM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037298L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.