Individual provider Active NPI

Janice Kathryn Pliszczak, DDS

  • Dentist
  • Syracuse, NY
National Provider Identifier
1528065497
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D43169 Issued in NY
Practice address
4525 W Seneca Tpke
Syracuse, NY 13215-9785
Phone
(315) 469-3229
Fax
(315) 469-4916
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D43169 NY Primary

Addresses

Primary practice location

4525 W Seneca Tpke
Syracuse, NY 13215-9785

Mailing address

4525 W Seneca Tpke
Syracuse, NY 13215-9785
Phone (315) 469-3229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150616002678 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6204147341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D43169NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528065497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159785",
            "telephone_number": "315-469-3229",
            "fax_number": "315-469-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159785",
            "telephone_number": "315-469-3229",
            "fax_number": "315-469-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLISZCZAK",
        "first_name": "JANICE",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "D43169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.