Active NPI
Jonathon Edward Rusnak, DDS
- Dentist
- Lake Charles, LA
National Provider Identifier
1891083515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6067
- Practice address
- 2629 Country Club Rd
Lake Charles, LA 70605-5911 - Phone
- (337) 474-3636
- Fax
- (337) 474-0110
- NPI assigned
- Jul 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6067 | LA | Primary |
Addresses
Primary practice location
2629 Country Club Rd
Lake Charles, LA 70605-5911
Mailing address
2629 Country Club Rd
Lake Charles, LA 70605-5911
Phone (337) 474-3636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6067 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robinson Dental Group | 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.
-
- General Practice Dentistry
- Lake Charles, LA
- NPI 1154628519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310688000000",
"number": "1891083515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2629 COUNTRY CLUB RD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055911",
"telephone_number": "337-474-3636",
"fax_number": "337-474-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2629 COUNTRY CLUB RD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055911",
"telephone_number": "337-474-3636",
"fax_number": "337-474-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSNAK",
"first_name": "JONATHON",
"middle_name": "EDWARD",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-15",
"last_updated": "2011-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
- Sydney Dianna Rudy, DPM
- Robert L Rumsey, MD
- Rural Healthcare Developers of Louisiana LLC (Calcasieu Oaks Psychiatric Hospital)
- Rural Healthcare Developers of Louisiana LLC (South Cameron Rural Health Clinic)
- Ronald R Rush, L.C.S.W., L.M.F.T.
- Kimberly Russell
- Jacob D Ryan, CRNA
- Zachary Ryder, M.D.
- Ryse Chiropractic LLC
- Richard Anthony Sachitano, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.