Mark Kozlowski, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30016184 Issued in OH

Practice address

1000 W Wallings Rd
Suite D
Broadview HTS, OH 44147-1200

Phone

(440) 546-9522

Fax

(440) 546-9564

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marek Kozlowski Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508903063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W WALLINGS RD",
            "address_2": "SUITE D",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441471200",
            "telephone_number": "440-546-9522",
            "fax_number": "440-546-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W WALLINGS RD",
            "address_2": "SUITE D",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441471200",
            "telephone_number": "440-546-9522",
            "fax_number": "440-546-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "MARK",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30016184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAREK",
            "last_name": "KOZLOWSKI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in Broadview HTS, OH
• Providers in Broadview HTS, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.