Individual provider Active NPI

Paul Chester Kazmer Jr., DMD

  • Periodontics
  • Cary, NC
National Provider Identifier
1922109677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6578 Issued in NC
Practice address
130 Preston Executive Dr
Suite #204
Cary, NC 27513-8433
Phone
(919) 468-6410
Fax
(919) 468-4314
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6578 NC Primary

Addresses

Primary practice location

130 Preston Executive Dr
Suite #204
Cary, NC 27513-8433

Mailing address

130 Preston Executive Dr
Suite #204
Cary, NC 27513
Phone (919) 468-6410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150804005335 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345554317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6578NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul C. Kazmer, Jr.,DMD,Ms,PA Periodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922109677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PRESTON EXECUTIVE DR",
            "address_2": "SUITE #204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-468-6410",
            "fax_number": "919-468-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PRESTON EXECUTIVE DR",
            "address_2": "SUITE #204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138433",
            "telephone_number": "919-468-6410",
            "fax_number": "919-468-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZMER",
        "first_name": "PAUL",
        "middle_name": "CHESTER",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "6578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.