Individual provider Active NPI

Philip Joseph Znidarsic, DDS

  • General Practice Dentistry
  • Northfield, OH
National Provider Identifier
1760494389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.020524 Issued in OH
Practice address
147 E Aurora Rd
Northfield, OH 44067-2054
Phone
(330) 467-6466
Fax
(330) 467-5118
NPI assigned
Aug 12, 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 30.020524 OH Primary

Addresses

Primary practice location

147 E Aurora Rd
Northfield, OH 44067-2054

Mailing address

147 E Aurora Rd
Northfield, OH 44067-2054
Phone (330) 467-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20141226000505 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618290644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Philip J. Znidarsic DDS, LLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760494389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 E AURORA RD",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440672054",
            "telephone_number": "330-467-6466",
            "fax_number": "330-467-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 E AURORA RD",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440672054",
            "telephone_number": "330-467-6466",
            "fax_number": "330-467-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZNIDARSIC",
        "first_name": "PHILIP",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.020524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, OH

Sources for this page

Verify at the official NPI Registry.