Individual provider Active NPI

Thomas J Zbaracki Jr., DDS MS

  • Endodontics
  • Duluth, MN
National Provider Identifier
1568528404
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D8329 Issued in MN
Practice address
5005 Matterhorn Drive
Ste 1
Duluth, MN 55811
Phone
(218) 625-8630
Fax
(218) 625-8632
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D8329 MN Primary

Addresses

Primary practice location

5005 Matterhorn Drive
Ste 1
Duluth, MN 55811

Mailing address

5005 Matterhorn Drive
Ste 1
Duluth, MN 55811
Phone (218) 625-8630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150413001993 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870811359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D8329MNMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1568528404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 MATTERHORN DRIVE",
            "address_2": "STE 1",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55811",
            "telephone_number": "218-625-8630",
            "fax_number": "218-625-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 MATTERHORN DRIVE",
            "address_2": "STE 1",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55811",
            "telephone_number": "218-625-8630",
            "fax_number": "218-625-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZBARACKI",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D8329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.