DR. JACK URSIC PA NPI 1194944744

NPI Information

  • NPI: 1194944744
  • Provider Name: DR. JACK URSIC, PA
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 10025 HG TRUEMAN RD
    LUSBY, MD
    ZIP 20657
  • Phone: (410) 326-4078

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NPI Details

DR. JACK URSIC, PA is a general practice dentist in Lusby, MD. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. JACK URSIC, PA NPI is 1194944744. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10025 HG TRUEMAN RD
LUSBY, MD
ZIP 20657-861
Phone: (410) 326-4078
Fax: (410) 326-9311

The provider's authorized official is Connie Pruitt .
The authorized official title is Office Manager and has the following contact phone number (410) 326-4078.

The enumeration date for this NPI number is 4/24/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice7289MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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