Active NPI
Patrick Wesley Pawlowski, DDS
- General Practice Dentistry
- Grand Marais, MN
National Provider Identifier
1891225835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D13849
- Practice address
- 303 E. 3Rd Street
Grand Marais, MN 55604-5560 - Phone
- (630) 235-8447
- Fax
- (630) 235-8447
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D13849 | MN | Primary |
Addresses
Primary practice location
303 E. 3Rd Street
Grand Marais, MN 55604-5560
Mailing address
2S570 Thaddeus Cir
Glen Ellyn, IL 60137-7193
Phone (630) 235-8447
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 |
|---|---|---|---|
| D13849 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497312000000",
"number": "1891225835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2S570 THADDEUS CIR",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601377193",
"telephone_number": "630-235-8447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 E. 3RD STREET",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556045560",
"telephone_number": "630-235-8447",
"fax_number": "630-235-8447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAWLOWSKI",
"first_name": "PATRICK",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2017-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D13849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Marais, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.