Stacie Maximiek Mitchell, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS035256 Issued in PA

Practice address

310 Pine St
Danville, PA 17821-1956

Phone

(570) 275-2600

NPI assigned

Mar 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073637930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HILLSIDE DR",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178157722",
            "telephone_number": "570-387-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PINE ST",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178211956",
            "telephone_number": "570-275-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "STACIE",
        "middle_name": "MAXIMIEK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS035256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayme Noelle Mirarchi
• William M. Mirenda, M.D.
• Seyedbabak Mirminachi, M.D.
• Kunal Mishra, DO
• Micaela Diane Mitchell
• Aastha Mittal, M.D.
• Jeremy Alexander Mock, M.D.
• Ayesha Moghul
• Mohamad Abdelrauf Mohamad, MD
• Ahmed Ayman Mohamed, MD

• Dentist in Danville, PA
• Providers in Danville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.