Active NPI
Dustin Jacob Prusik, DDS
- General Practice Dentistry
- Cary, NC
National Provider Identifier
1558774885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9726
- Practice address
- 230 Dove Cottage LN
Cary, NC 27519-0505 - Phone
- (919) 345-1501
- NPI assigned
- Jun 4, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9726 | NC | Primary |
Addresses
Primary practice location
230 Dove Cottage LN
Cary, NC 27519-0505
Mailing address
230 Dove Cottage LN
Cary, NC 27519-0505
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9726 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dustin J. Prusik, DDS, PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Apex, NC
- NPI 1548616733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1558774885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 DOVE COTTAGE LN",
"city": "CARY",
"state": "NC",
"postal_code": "275190505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 DOVE COTTAGE LN",
"city": "CARY",
"state": "NC",
"postal_code": "275190505",
"telephone_number": "919-345-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUSIK",
"first_name": "DUSTIN",
"middle_name": "JACOB",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-04",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "9726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.