John Anthony Marcuzzo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4987 Issued in NE

Practice address

1304 Harlan Dr
Bellevue, NE 68005-3648

Phone

(402) 291-4411

Fax

(402) 291-0747

NPI assigned

Nov 6, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Today'S Dental Bellevue, LLC

  • Dentist
  • Bellevue, NE
  • NPI 1710523097

  General Practice

  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629147608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 HARLAN DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053648",
            "telephone_number": "402-291-4411",
            "fax_number": "402-291-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 HARLAN DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053648",
            "telephone_number": "402-291-4411",
            "fax_number": "402-291-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUZZO",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "4987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-0-638-721-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bellevue, NE
• Providers in Bellevue, NE by specialty
• General Practice Dentistry in Nebraska

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.