Individual provider Active NPI

Gary Peter Swistak, D.D.S.

  • Dentist
  • Orchard Park, NY
National Provider Identifier
1679799654
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
037407 Issued in NY
Practice address
3326 Southwestern Blvd
Orchard Park, NY 14127-1524
Phone
(716) 636-8686
Fax
(716) 677-4358
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 037407 NY Primary

Addresses

Primary practice location

3326 Southwestern Blvd
Orchard Park, NY 14127-1524

Mailing address

3326 Southwestern Blvd
Orchard Park, NY 14127-1524
Phone (716) 636-8686

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
037407NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1679799654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271524",
            "telephone_number": "716-636-8686",
            "fax_number": "716-677-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271524",
            "telephone_number": "716-636-8686",
            "fax_number": "716-677-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWISTAK",
        "first_name": "GARY",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "037407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.