Individual provider Active NPI

John J Scieszinski, D.D.S.

  • General Practice Dentistry
  • Albia, IA
National Provider Identifier
1780710186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
06696 Issued in IA
Practice address
26 S Main St
Albia, IA 52531-2041
Phone
(641) 932-2729
Fax
(641) 932-7036
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 06696 IA Primary

Addresses

Primary practice location

26 S Main St
Albia, IA 52531-2041

Mailing address

26 S Main St
Albia, IA 52531-2041
Phone (641) 932-2729

Other identifiers 3

IdentifierTypeStateIssuer
EJ0065OtherIAJOHN DEERE
1184333MedicaidIA
184333OtherIADELTA DENTAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20150605000513 IA Order and Referring Only - DentistPractitioner - Dentist 1850612680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780710186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S MAIN ST",
            "city": "ALBIA",
            "state": "IA",
            "postal_code": "525312041",
            "telephone_number": "641-932-2729",
            "fax_number": "641-932-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S MAIN ST",
            "city": "ALBIA",
            "state": "IA",
            "postal_code": "525312041",
            "telephone_number": "641-932-2729",
            "fax_number": "641-932-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIESZINSKI",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "EJ0065",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184333",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "184333",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albia, IA

Sources for this page

Verify at the official NPI Registry.