Individual provider Active NPI

Frantisek Vytykac, D,D.S.

  • General Practice Dentistry
  • Maspeth, NY
National Provider Identifier
1639259492
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045063 Issued in NY
Practice address
6230 60TH Dr
Maspeth, NY 11378-3524
Phone
(718) 821-2933
Fax
(718) 418-6585
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 045063 NY Primary

Addresses

Primary practice location

6230 60TH Dr
Maspeth, NY 11378-3524

Mailing address

6230 60TH Dr
Maspeth, NY 11378-3524
Phone (718) 821-2933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160316001542 NY Order and Referring Only - DentistPractitioner - Dentist 6709182702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045063NYMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639259492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 60TH DR",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113783524",
            "telephone_number": "718-821-2933",
            "fax_number": "718-418-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 60TH DR",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113783524",
            "telephone_number": "718-821-2933",
            "fax_number": "718-418-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYTYKAC",
        "first_name": "FRANTISEK",
        "name_prefix": "Dr.",
        "credential": "D,D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maspeth, NY

Sources for this page

Verify at the official NPI Registry.