Larry J Skoczylas, D.D.S., M.S.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

LS014616 Issued in MI

Practice address

6112 Merlin CT
Midland, MI 48640-7358

Phone

(989) 839-9979

Fax

(989) 839-9553

NPI assigned

Jul 13, 2006

Last updated

Oct 10, 2012By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1437174786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 MERLIN CT",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407358",
            "telephone_number": "989-839-9979",
            "fax_number": "989-839-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 MERLIN CT",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407358",
            "telephone_number": "989-839-9979",
            "fax_number": "989-839-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCZYLAS",
        "first_name": "LARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "LS014616",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "LS014616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2993779",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2847912",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charanjeet Singh
• Todd Sirrine, O.T.R./L
• Tiffany Lynn Sito, AGNP-C
• Gordon Siu, RN
• Cynthia Ann Skiba, DDS
• Jonathon George Skurya, MD
• Leajo Slabic
• Alicia M Slack
• Jared Slater, AT
• Sarah L Slavik, NP

• Oral & Maxillofacial Surgery (D.M.D.) in Midland, MI
• Providers in Midland, MI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.