Active NPI
Ethan A Pansick, DDS MS
- Dentist
- Delray Beach, FL
National Provider Identifier
1447404637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 13351
- Practice address
- 6290 Linton Blvd
Suite 104
Delray Beach, FL 33484-6409 - Phone
- (561) 496-6855
- NPI assigned
- Nov 14, 2008
- Sex
- Male
- Sole proprietor
- No
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 | DN 13351 | NY | Primary |
Addresses
Primary practice location
6290 Linton Blvd
Suite 104
Delray Beach, FL 33484-6409
Mailing address
6290 Linton Blvd
Suite 104
Delray Beach, FL 33484-6409
Phone (561) 496-6855
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 13351 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394409600000",
"number": "1447404637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6290 LINTON BLVD",
"address_2": "SUITE 104",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334846409",
"telephone_number": "561-496-6855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6290 LINTON BLVD",
"address_2": "SUITE 104",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334846409",
"telephone_number": "561-496-6855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANSICK",
"first_name": "ETHAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-14",
"last_updated": "2014-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "DN 13351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delray Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.