NPIMap

Organization Active NPI

J. Michael Panczyszyn, D.D.S., PA

  • Dental Clinic/Center
  • Port Orange, FL
National Provider Identifier
1932373636
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN0009950 Issued in FL
Legal business name
J. MICHAEL PANCZYSZYN, D.D.S., PA
Practice address
938 Bridgewater Dr
Unit 3B
Port Orange, FL 32129-6108
Phone
(386) 756-3728
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
J. Michael Panczyszyn, D.D.S.
Title
Dentist
Phone
(386) 756-3728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN0009950 FL Primary

Addresses

Primary practice location

938 Bridgewater Dr
Unit 3B
Port Orange, FL 32129-6108

Mailing address

938 Bridgewater Dr
Unit 3B
Port Orange, FL 32129-6108
Phone (386) 756-3728

National Provider Directory

National Provider Directory

Locations

938 Bridgewater Dr
Unit 3B
Port Orange, FL 32129
Phone (386) 756-3728

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1932373636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 BRIDGEWATER DR",
            "address_2": "UNIT 3B",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296108",
            "telephone_number": "386-756-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 BRIDGEWATER DR",
            "address_2": "UNIT 3B",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296108",
            "telephone_number": "386-756-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. MICHAEL PANCZYSZYN, D.D.S., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PANCZYSZYN",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "386-756-3728",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN0009950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.