RAYMOND J MAZUCHOWSKI JR. DDS
NPI 1255875944
Dentist in San Pedro, CA

Q: What is Raymond Mazuchowski's NPI number?

The NPI number for Raymond Mazuchowski is 1255875944. It was assigned to this individual provider in the NPPES registry on December 14, 2016.

Q: What is Raymond Mazuchowski's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since December 14, 2016PECOS Enrolled

697 S GAFFERY ST, SAN PEDRO, CA 90731(310) 925-3477 Get Directions Write a Review

NPPES record last updated: July 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 20, 2020, Dec 14, 2016 (2 updates tracked since 2016).

On this page

About Raymond J Mazuchowski Jr. Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAYMOND J MAZUCHOWSKI JR. DDS (NPI 1255875944) is an individual dentist in San Pedro, California, licensed in Wisconsin (1001463) and active in the NPI registry since December 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Green Bay.

NPPES Registry Identity

NPI1255875944

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameRAYMOND J MAZUCHOWSKI JR.Credential: DDS

Location Address697 S GAFFERY STSan Pedro, CA 90731

Mailing Address697 S Gaffey StSan Pedro, CA 90731-3026 · (310) 925-3477

Phone(310) 925-3477

Sole ProprietorYes

Enumeration DateDecember 14, 2016

Last NPPES UpdateJuly 20, 20202 updates tracked since enumeration

NPPES CertifiedJuly 20, 2020

✔ NPI 1255875944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in WI · 1001463

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

697 S GAFFERY ST, San Pedro, CA 90731

Open in Google Maps ↗

Secondary Practice Location 1

Location 11931 Main StGreen Bay, WI 54302-3920 · Phone (888) 988-4066 · Fax (847) 496-4850

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raymond J Mazuchowski Jr. Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90731 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raymond Mazuchowski's NPI number?

The NPI number for Raymond Mazuchowski is 1255875944. It was assigned to this individual provider in the NPPES registry on December 14, 2016.

Where is Raymond Mazuchowski located?

Raymond Mazuchowski practices at 697 S Gaffery St, San Pedro, CA 90731. The listed phone number is (310) 925-3477.

What is Raymond Mazuchowski's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Raymond Mazuchowski enrolled in Medicare?

Yes. Raymond Mazuchowski is registered in the Medicare PECOS enrollment system.

What insurance does Raymond Mazuchowski accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental of Wisconsin, Inc. and Guardian and 4 other insurers list Raymond Mazuchowski as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raymond Mazuchowski was last updated on July 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.