Organization Active NPI

Dr. Joseph M. Mazurek, Inc

  • Pediatric Dentistry
  • Little Rock, AR
National Provider Identifier
1669098208
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DR. JOSEPH M. MAZUREK, INC
Practice address
6500 Baseline Rd
Little Rock, AR 72209-4732
Phone
(501) 568-4733
Fax
(501) 568-4700
NPI assigned
Jun 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Mrs. Teresa L Mazurek
Title
Office Manager
Phone
(501) 568-4733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

6500 Baseline Rd
Little Rock, AR 72209-4732

Mailing address

6500 Baseline Rd
Little Rock, AR 72209-4732
Phone (501) 568-4733

Other identifiers 1

IdentifierTypeStateIssuer
112152608MedicaidAR

National Provider Directory

National Provider Directory

Locations

6500 Baseline Rd
Little Rock, AR 72209
Phone (501) 568-4733

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1669098208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 BASELINE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722094732",
            "telephone_number": "501-568-4733",
            "fax_number": "501-568-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 BASELINE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722094732",
            "telephone_number": "501-568-4733",
            "fax_number": "501-568-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOSEPH M. MAZUREK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "MAZUREK",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-568-4733",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112152608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.