Individual provider Active NPI

William Michael Brzeczka Jr., DDS

  • General Practice Dentistry
  • Boynton Beach, FL
National Provider Identifier
1962924795
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN23216 Issued in FL
Practice address
11135 S Jog Rd Ste 3
Boynton Beach, FL 33437-1817
Phone
(561) 733-3361
NPI assigned
Jul 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 059998 NY
General Practice Dentistry 1223G0001X DN23216 FL Primary

Addresses

Primary practice location

11135 S Jog Rd Ste 3
Boynton Beach, FL 33437-1817

Mailing address

11135 S Jog Rd Ste 3
Boynton Beach, FL 33437-1817
Phone (561) 733-3361

Other practice location 1

337 Lenox Ave
New York, NY 10027-3703
Phone (646) 585-1515

Other practice location 2

2336 Grand Concourse
Bronx, NY 10458-6903
Phone (718) 220-0439

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address premierdental347@bellsouth.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN23216FLMDGeneral Practice Dentistry
059998NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, P.a. General Practice CurrentSince Dec 22, 2024 Accepting new patients
David Green DDS PA General Practice PastSince Sep 12, 2021 Accepting new patients

Locations

11135 S Jog Rd
Ste 3
Boynton Beach, FL 33437
Phone (561) 733-3361

Organizations & group practices 2

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": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1962924795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11135 S JOG RD STE 3",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334371817",
            "telephone_number": "561-733-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11135 S JOG RD STE 3",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334371817",
            "telephone_number": "561-733-3361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "337 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100273703",
            "country_code": "US",
            "telephone_number": "646-585-1515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2336 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104586903",
            "country_code": "US",
            "telephone_number": "718-220-0439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRZECZKA",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059998",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "premierdental347@bellsouth.net",
            "affiliation": "N",
            "address_1": "11135 S Jog Rd Ste 3",
            "city": "Boynton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334371817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.