Individual provider Active NPI

John E Smolnicky, D. D. S

  • Dentist
  • Valparaiso, IN
National Provider Identifier
1508010042
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12008756A Issued in IN
Practice address
1751 Thornapple Cir
Valparaiso, IN 46385-6164
Phone
(219) 464-1141
Fax
(219) 923-8873
NPI assigned
Nov 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12008756A IN Primary

Addresses

Primary practice location

1751 Thornapple Cir
Valparaiso, IN 46385-6164

Mailing address

1751 Thornapple Cir
Valparaiso, IN 46385-6164
Phone (219) 464-1141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20201006002428 IN Practitioner - Dentist 4688964455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Community Mental Health Center Inc. CurrentSince Sep 5, 2020 Accepting new patients
Southlake Community Mental Health Center Inc. Past Accepting new patients
Wong & Smolnicky P C Past Accepting new patients

Locations

4022 Hohman Ave
Hammond, IN 46327
Phone (219) 937-3300

8555 Taft St
Merrillville, IN 46410
Phone (219) 736-7232

8400 Louisiana St
Merrillville, IN 46410
Phone (219) 757-1924

Interoperability endpoints

  • Direct secure messaging: john.smolnicky.p1@direct.geminus.nextgenshare.com

Organizations & group practices 3

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": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1508010042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 THORNAPPLE CIR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463856164",
            "telephone_number": "219-464-1141",
            "fax_number": "219-923-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 THORNAPPLE CIR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463856164",
            "telephone_number": "219-464-1141",
            "fax_number": "219-923-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLNICKY",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D. D. S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008756A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.