Individual provider Active NPI

John Thomas Zupancic, DDS

  • General Practice Dentistry
  • Hibbing, MN
National Provider Identifier
1891809224
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10700 Issued in MN
Practice address
1515 E 25TH St
C-153
Hibbing, MN 55746-3354
Phone
(218) 263-2916
Fax
(218) 263-2971
NPI assigned
Aug 19, 2006
Last updated
May 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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 10700 MN Primary

Addresses

Primary practice location

1515 E 25TH St
C-153
Hibbing, MN 55746-3354

Mailing address

1515 E 25TH St
C-153
Hibbing, MN 55746-3354
Phone (218) 263-2916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150506002461 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456670843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10700MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1891809224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E 25TH ST",
            "address_2": "C-153",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463354",
            "telephone_number": "218-263-2916",
            "fax_number": "218-263-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E 25TH ST",
            "address_2": "C-153",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463354",
            "telephone_number": "218-263-2916",
            "fax_number": "218-263-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUPANCIC",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hibbing, MN

Sources for this page

Verify at the official NPI Registry.