Individual provider Active NPI

Michael C Sivik, D.M.D.

  • General Practice Dentistry
  • Ashtabula, OH
National Provider Identifier
1578714796
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22904 Issued in OH
Practice address
5005 State Rd
Ashtabula, OH 44004-6265
Phone
(440) 992-3146
Fax
(440) 998-6932
NPI assigned
Oct 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22904 OH Primary

Addresses

Primary practice location

5005 State Rd
Ashtabula, OH 44004-6265

Mailing address

5005 State Rd
Ashtabula, OH 44004-6265
Phone (440) 992-3146

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

LicenseStateTypeSpecialty
22904OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula Sleep Medicine LLC General Practice Current Accepting new patients
Sleep Impressions, LLC Past Accepting new patients

Locations

5005 State Rd
Ashtabula, OH 44004
Phone (440) 992-3146

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1578714796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046265",
            "telephone_number": "440-992-3146",
            "fax_number": "440-998-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046265",
            "telephone_number": "440-992-3146",
            "fax_number": "440-998-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVIK",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "22904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.