Individual provider Active NPI

Stephen Sylwestrak, DDS

  • Dentist
  • Rochester, MN
National Provider Identifier
1417484429
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D13832 Issued in MN
Practice address
973 Skyline Dr SW
Rochester, MN 55902-1220
Phone
(507) 424-1040
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13832 MN Primary

Addresses

Primary practice location

973 Skyline Dr SW
Rochester, MN 55902-1220

Mailing address

3055 Brittany LN NW Apt D
Rochester, MN 55901-7016
Phone (630) 927-2600

Other practice location 1

18 3rd St SW
Rochester, MN 55902-3024
Phone (507) 258-5260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170721002444 MN Order and Referring Only - DentistPractitioner - Dentist 7315217486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Tree Dental 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.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417484429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 BRITTANY LN NW APT D",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559017016",
            "telephone_number": "630-927-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 SKYLINE DR SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021220",
            "telephone_number": "507-424-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 3rd St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559023024",
            "country_code": "US",
            "telephone_number": "507-258-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYLWESTRAK",
        "first_name": "STEPHEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.