Gerald William Paczkowski Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5372015 Issued in WI

Practice address

1614 Washington Street
Two Rivers, WI 52421

Phone

(920) 794-8911

NPI assigned

Oct 2, 2006

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

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

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.

• Paczkowski Family Dental, S.C.

  • Dentist
  • Two Rivers, WI
  • NPI 1962621243
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962596387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 WASHINGTON STREET",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "52421",
            "telephone_number": "920-794-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 WASHINGTON STREET",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "52421",
            "telephone_number": "920-794-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACZKOWSKI",
        "first_name": "GERALD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5372015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark R Oleck, CRNA
• Shilea Kaye Olson
• Ganna V Oosting, M.D.
• Paczkowski Family Dental, S.C.
• Gerald William Paczkowski, D.D.S.
• Christopher J Painter, M.D.
• Emil M Pajek, M.D.
• Neil Bain Patterson, DO
• Laura Peck
• Michelle K Petersen, NP

• General Practice Dentistry in Two Rivers, WI
• Providers in Two Rivers, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.