John Pastorek, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2013014064 Issued in MO

Practice address

3445 Pheasant Meadow Dr
O Fallon, MO 63368-7324

Phone

(636) 240-0232

Fax

(636) 240-0368

NPI assigned

May 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Missouri Dental Professionals, Richard Straus, DMD, PC

  • General Practice Dentistry
  • O Fallon, MO
  • NPI 1356632350
  NPD (past)

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1801155874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 PHEASANT MEADOW DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687324",
            "telephone_number": "636-240-0232",
            "fax_number": "636-240-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 PHEASANT MEADOW DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687324",
            "telephone_number": "636-240-0232",
            "fax_number": "636-240-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTOREK",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2013014064",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Panasci, MD
• Joan Marie Papin, SLP, CCC
• Erica Ann Parker, ADMINISTRATER
• Bradley John Parks, PHARMD
• Sarah Ellen Parson, M.S CCC-SLP
• Sarah Patriarca
• Kathleen A Patrick, MA,LPC
• Michael Edward Patterson III
• Ronald Edward Patterson, CRNFA, CNOR
• Billi J Patzius, PHD

• General Practice Dentistry in O Fallon, MO
• Providers in O Fallon, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.