Individual provider Active NPI

Bernard Dennis Nowicki, HIS DISPENCER

  • Hearing Instrument Specialist
  • Glendale, AZ
National Provider Identifier
1508004748
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1351 Issued in AZ
Practice address
14021 N 51St Ave
Suite 101
Glendale, AZ 85306-4838
Phone
(602) 863-1020
Fax
(602) 863-1020
NPI assigned
Jan 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1351 AZ Primary

Addresses

Primary practice location

14021 N 51St Ave
Suite 101
Glendale, AZ 85306-4838

Mailing address

14021 N 51St Ave
Suite 101
Glendale, AZ 85306-4838
Phone (602) 863-1020

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

State licenses

LicenseStateTypeSpecialty
1351AZMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1508004748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14021 N 51ST AVE",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064838",
            "telephone_number": "602-863-1020",
            "fax_number": "602-863-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14021 N 51ST AVE",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064838",
            "telephone_number": "602-863-1020",
            "fax_number": "602-863-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWICKI",
        "first_name": "BERNARD",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "HIS DISPENCER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "AZ",
            "license": "1351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.