Nicholas J Drzycimski, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6558 Issued in IA

Practice address

2727 N 15TH St
Fort Dodge, IA 50501-7203

Phone

(515) 576-5786

Fax

(515) 576-5128

NPI assigned

Feb 13, 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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 13, 2015 through Jun 13, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rolling Hills Dental Clinic PC

  • Dental Clinic/Center
  • Fort Dodge, IA
  • NPI 1790237204
  NPD (past) Authorized official
• Maria K Becker DDS PC

  • Dental Clinic/Center
  • Fort Dodge, IA
  • NPI 1174261721
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629110085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1823",
            "address_2": "2727 NORTH 15TH STREET",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505011823",
            "telephone_number": "515-576-5786",
            "fax_number": "515-576-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N 15TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505017203",
            "telephone_number": "515-576-5786",
            "fax_number": "515-576-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRZYCIMSKI",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "843081",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500132",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "192898",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Doyle, PHARMD
• Dr John Garton
• Dr Ryan J Brown PC
• Breann Drees, MS, LAT, ATC, CSCS
• Steven Drew, CADC
• Marie Joan Duclos
• Rey Exclamador Dumaog
• Gerald Peter Dunn
• Megan Renee Eastman, ARNP
• Mariah Raeann Eastwood

• General Practice Dentistry in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• General Practice Dentistry in Iowa

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.