Peter Porazik, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44062 Issued in CA

Practice address

2045 Lebec Road
Lebec, CA 93243

Phone

(661) 245-1434

Fax

(661) 245-2730

NPI assigned

Jan 23, 2007

Last updated

Dec 7, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1467506444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22351 BARBACOA DR",
            "city": "SAUGUS",
            "state": "CA",
            "postal_code": "913502249",
            "telephone_number": "661-296-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 LEBEC ROAD",
            "city": "LEBEC",
            "state": "CA",
            "postal_code": "93243",
            "telephone_number": "661-245-1434",
            "fax_number": "661-245-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORAZIK",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Rachelle Kast
• Melissa Michele Luongo
• Robert Martinez, M.D.
• Elizabeth J Megaw
• Mariaannabella Rusen Porazik, D.D.S.
• Prosperous Health Lake Hughes
• Victor Gabriel Ramirez
• Reggies Recovery II LLC
• Ana Maria Silva
• Sunrise Recovery LLC

• General Practice Dentistry in Lebec, CA
• Providers in Lebec, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.