Michael Pysnak, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D-4724 Issued in ID

Practice address

349 W Iowa Ave
Nampa, ID 83686-2856

Phone

(208) 467-5100

NPI assigned

Feb 18, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children'S Dentistry of Idaho, PLLC

  • Pediatric Dentistry
  • Nampa, ID
  • NPI 1689942849
  NPD (past)
• Children'S Dentistry PLLC

  • Pediatric Dentistry
  • Nampa, ID
  • NPI 1932372026
  NPD (past)
• Childrens Dentistry of Fruitland

  • Pediatric Dentistry
  • Fruitland, ID
  • NPI 1619634250
  NPD (past)

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1922467992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYSNAK",
        "first_name": "MICHAEL",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-18",
        "last_updated": "2021-12-03",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D-4724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaleb Pulsipher, DPT
• Sarah Punzel
• Paige Allison Bethel Purnell
• Erika Lynn Putnam, DC
• Lauryn Pyke, PA-C
• Jennie Quaine, M.D.
• Audrey Quenzer, MS CCC-SLP
• Quest Counseling LLC
• Quest Diagnostics Clinical Laboratories Inc
• Quick Recovery Chiropractic PLLC

• Pediatric Dentistry in Nampa, ID
• Providers in Nampa, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.