Individual provider Active NPI

Ilona K Ziatyk, DMD

  • Dentist
  • Gainesville, FL
National Provider Identifier
1912566571
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN24164 Issued in FL
Practice address
5021 NW 34TH Blvd Ste a
Gainesville, FL 32605-1191
Phone
(954) 864-1022
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24164 FL Primary

Addresses

Primary practice location

5021 NW 34TH Blvd Ste a
Gainesville, FL 32605-1191

Mailing address

4455 SW 34TH St Apt Dd163
Gainesville, FL 32608-6538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190711000831 FL Order and Referring Only - DentistPractitioner - Dentist 9133454291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1912566571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 SW 34TH ST APT DD163",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326086538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 NW 34TH BLVD STE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326051191",
            "telephone_number": "954-864-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIATYK",
        "first_name": "ILONA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.