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Export Provider Record NPI 1205828241
Jon R DvorakMD
Active
NPI Number1205828241
NPI TypeNPI-1 Individual
SpecialtyPediatrics
Provider Details
NPI1205828241
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2005-08-16
Last Updated2023-11-03
Mailing Address1601 Brigham Dr, Suite 200
Perrysburg, OH 43551-7114
United States
Phone: (419) 872-7700 | Fax: (419) 874-0196
📍 View Map
Primary Practice Address1601 Brigham Dr, Suite 200
Perrysburg, OH 43551-7114
United States
Phone: (419) 872-7700 | Fax: (419) 874-0196
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)OH000000141200Anthem
Other (non-Medicare)OH00010PHC
Other (non-Medicare)OH0633991Aetna
MEDICAIDOH0666275-
Other (non-Medicare)OH12-01216UHC
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes208000000X – PediatricsOH35052934
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About NPI 1205828241

Jon R Dvorak MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1205828241. The primary specialty listed is Pediatrics. The provider is located in Perrysburg, OH. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-08-16. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1205828241?

NPI 1205828241 belongs to Jon R Dvorak MD, a Pediatrics in Perrysburg, OH. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1205828241 active?

The current status of NPI 1205828241 in the NPPES registry is Active. The record was last updated on 2023-11-03.

What specialty is NPI 1205828241?

NPI 1205828241 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1205828241?

You can verify NPI 1205828241 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1205828241?

The primary practice address on file for NPI 1205828241 is 1601 Brigham Dr, Perrysburg, OH 43551-7114. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1205828241 issued?

NPI 1205828241 was first issued (enumerated) on 2005-08-16. The NPPES record was last updated on 2023-11-03.

Practice Location Map

Jon R Dvorak is located at 1601 Brigham Dr, Perrysburg, OH. Use the map below to find directions or verify the practice location.

📍 1601 Brigham Dr, Perrysburg, OH 43551-7114  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Jon R Dvorak. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1205828241. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pediatrics35052934OH
Data Verified from CMS NPPES Last synced: 2026-08-30 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162