DR. WILLIAM KONICKI DMD, MD
NPI 1285014662
Student in an Organized Health Care Education/Training Program in Wake Forest, NC
About Dr. William Konicki Dmd, Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WILLIAM KONICKI DMD, MD (NPI 1285014662) is an individual student in an organized health care education/training program in Wake Forest, North Carolina and active in the NPI registry since June 2015. He has opted out of Medicare through September 10, 2027 and maintains a secondary practice location in New York.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. William Konicki Dmd, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 10, 2021 through September 10, 2027.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 William Konicki's NPI number?
The NPI number for William Konicki is 1285014662. It was assigned to this individual provider in the NPPES registry on June 1, 2015.
Where is William Konicki located?
William Konicki practices at 1711 S Main St, Wake Forest, NC 27587. The listed phone number is (919) 841-1720.
What is William Konicki's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is William Konicki enrolled in Medicare?
No. William Konicki has opted out of Medicare through September 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does William Konicki accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of NC and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list William Konicki 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 William Konicki was last updated on November 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.
# Dr. William Konicki, DMD, MD · NPI 1285014662
Student in an Organized Health Care Education/Training Program provider in Wake Forest, North Carolina. Individual provider, active in the CMS NPPES registry since June 1, 2015.
## Identity
- **NPI:** 1285014662 (Entity type: Individual)
- **Enumerated:** June 1, 2015
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1711 S MAIN ST, Wake Forest, NC 27587-9287
- **Phone:** (919) 841-1720
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through September 10, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** November 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1285014662) · Data from the CMS NPPES public registry.