Paul J Nawiesniak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-020493 Issued in IL

Practice address

238 Brookley Ave SW
579 MDG
Bolling Afb, DC 20032-7704

Phone

(703) 681-7127

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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 TN

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

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1891800587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 BRADFORD WAY",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015861",
            "telephone_number": "301-694-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 BROOKLEY AVE SW",
            "address_2": "579 MDG",
            "city": "BOLLING AFB",
            "state": "DC",
            "postal_code": "200327704",
            "telephone_number": "703-681-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWIESNIAK",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-020493",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyanna Marquez
• Margaret Barnes Matarese, M.D.
• Mark Edward Mavity, MD, MPH
• William Gary Meyer, M.D.
• Katherine R. Morgnti IV, D.D.S., M.P.H.
• Ben Onnink, MD
• Eric Joseph Palte, DDS
• Jameka Parker
• Kerry Allison Phelan, O.D.
• David G Ray, PHD

• General Practice Dentistry in Bolling Afb, DC
• Providers in Bolling Afb, DC by specialty
• General Practice Dentistry in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.