John R Sedlak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4341 Issued in NE

Practice address

424 Grand Ave
Burwell, NE 68823

Phone

(308) 346-4988

Fax

(308) 346-9103

NPI assigned

Oct 18, 2006

Last updated

May 29, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Burwell Dental Clinic, P.C.

  • General Practice Dentistry
  • Burwell, NE
  • NPI 1609157999
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1932280757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 LAKESHORE DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685281434",
            "telephone_number": "402-488-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 GRAND AVE",
            "city": "BURWELL",
            "state": "NE",
            "postal_code": "68823",
            "telephone_number": "308-346-4988",
            "fax_number": "308-346-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLAK",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "4341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080081000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Burwell, NE
• Providers in Burwell, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.