Michael Anthony Mercurio Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0459651 Issued in NY

Practice address

235 Central Ave
Silver Creek, NY 14136-1221

Phone

(716) 934-4977

Fax

(716) 934-7036

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154490928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3459 CREEKVIEW DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753643",
            "telephone_number": "716-646-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CENTRAL AVE",
            "city": "SILVER CREEK",
            "state": "NY",
            "postal_code": "141361221",
            "telephone_number": "716-934-4977",
            "fax_number": "716-934-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCURIO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0459651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01664846",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amie E Libby
• Carolyn Jane Lukonaitis, DC
• Arawins Andrew Manoharan, M.D.
• Thomas McTernan, M.D.
• Peggy Ann Meadows, RN
• Marjorie A Murphy, CPNP
• Darci Paul, MT-BC
• Layna B. Pelletter, MS, CCC/SLP
• Stephen Pericak, D.D.S.
• Tracy Louise Peron, M.ED.

• General Practice Dentistry in Silver Creek, NY
• Providers in Silver Creek, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.