Periza Zaninovic, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901600691 Issued in MI

Practice address

123 Marmont Street
Niles, MI 49120

Phone

(512) 931-2190

Fax

(512) 869-2940

NPI assigned

Apr 26, 2007

Last updated

Oct 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1891746970
  Medicare reassignment NPD
• Periza Zaninovic DDS PC

  • General Practice Dentistry
  • Niles, MI
  • NPI 1003565086
  NPD Authorized official
• Lone Star Circle of Care

  dba Lone Star Circle of Care Adult Medicine at St. John

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1679351555
  NPD
• Lone Star Circle of Care

  dba Lone Star Circle of Care at Collinfield

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1699289728
  NPD
• Richard L. Beckermeyer, D. D. S., P.C.

  • Dental Clinic/Center
  • Niles, MI
  • NPI 1619191178
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1841410727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MARMONT STREET",
            "city": "NILES",
            "state": "MI",
            "postal_code": "49120",
            "telephone_number": "512-931-2190",
            "fax_number": "512-869-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MARMONT STREET",
            "city": "NILES",
            "state": "MI",
            "postal_code": "49120",
            "telephone_number": "512-931-2190",
            "fax_number": "512-869-2940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 E 3rd St.",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "92408",
            "country_code": "US",
            "telephone_number": "909-382-7120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "802 Avenue J",
            "address_purpose": "LOCATION",
            "city": "Marble Falls",
            "state": "TX",
            "postal_code": "786545125",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "fax_number": "830-693-2481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 Old Austin Hwy",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "TX",
            "postal_code": "786025034",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "fax_number": "512-332-6894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2120 N Mays St Ste 430",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786642108",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "fax_number": "512-255-6404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2411 Williams Dr Ste 111",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "TX",
            "postal_code": "786283268",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "fax_number": "512-863-1447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZANINOVIC",
        "first_name": "PERIZA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600691",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20101",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "473472",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE  LICENSE NUMBER",
            "identifier": "47342",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Denise Wright, OTR
• Ellen Renee Wyant, D.M.D.
• Vicki L Yarbro
• Ashley Yoder
• John Mourad Zakhary, MD
• Elizabeth Zech, NP
• Jennifer Lynn Zizzo, NP

• Dentist in Niles, MI
• Providers in Niles, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.