Individual provider Active NPI

Kenneth Zlotkowski, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1871860460
Registry record updated Nov 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019020651 Issued in IL
Practice address
3218 W 115TH St
Chicago, IL 60655-2805
Phone
(773) 233-6800
Fax
(773) 233-7221
NPI assigned
Nov 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2011

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 019020651 IL Primary

Addresses

Primary practice location

3218 W 115TH St
Chicago, IL 60655-2805

Mailing address

3218 W 115TH St
Chicago, IL 60655-2805
Phone (773) 233-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20161205001021 IL Order and Referring Only - DentistPractitioner - Dentist 6305126574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Zlotkowski & Papanicolas, Inc 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": "1322265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322265600000",
    "number": "1871860460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 W 115TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552805",
            "telephone_number": "773-233-6800",
            "fax_number": "773-233-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 W 115TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552805",
            "telephone_number": "773-233-6800",
            "fax_number": "773-233-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZLOTKOWSKI",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-26",
        "last_updated": "2011-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.