Michael Kutsyk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

059297 Issued in NY

Practice address

10014 US Highway 301 N
Parrish, FL 34219-8493

Phone

(941) 842-2240

NPI assigned

Feb 13, 2016

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 FL

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

Practice roles

Locations

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.

• Destination DNTL, P.a.

  • Dental Clinic/Center
  • Parrish, FL
  • NPI 1710678057
  NPD Authorized official

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

{
    "created_epoch": "1455321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1508225939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10014 US HIGHWAY 301 N",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342198493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10014 US HIGHWAY 301 N",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342198493",
            "telephone_number": "941-842-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTSYK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-13",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sivilay Keovilay
• Ebony King, RN
• George Earl Klein, DPT
• Sheldon Klein, PHARMACIST
• Kristin Lasche Kunjappan, PHARMD
• Kathryn I. Lake, APRN
• Kristine Lamb
• Du Phu Le, PHARM D
• Phuong Anh Le, RPH
• Roshni Marballi Leboutillier, DO

• General Practice Dentistry in Parrish, FL
• Providers in Parrish, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.