Individual provider Active NPI

James B. Omecinski Jr., D.D.S.

  • General Practice Dentistry
  • Victoria, TX
National Provider Identifier
1902994940
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19157 Issued in TX
Practice address
306 E Airline Rd
Victoria, TX 77901-3902
Phone
(361) 573-4701
Fax
(361) 485-9526
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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 19157 TX Primary

Addresses

Primary practice location

306 E Airline Rd
Victoria, TX 77901-3902

Mailing address

306 E Airline Rd
Victoria, TX 77901-3964
Phone (361) 573-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160601001211 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4082904248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19157TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1902994940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E AIRLINE RD",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013964",
            "telephone_number": "361-573-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E AIRLINE RD",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013902",
            "telephone_number": "361-573-4701",
            "fax_number": "361-485-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMECINSKI",
        "first_name": "JAMES",
        "middle_name": "B.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.