NPIMap

Organization Active NPI

Mercy Dental Group, LLC

  • General Practice Dentistry
  • Middleton, WI
National Provider Identifier
1174129019
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MERCY DENTAL GROUP, LLC
Practice address
6660 University Ave.
Middleton, WI 53562
Phone
(608) 836-1446
NPI assigned
Dec 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Mr. Darren Thomas Marabelli
Title
Chief Operating Officer
Phone
(608) 609-4023

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

6660 University Ave.
Middleton, WI 53562

Mailing address

6660 University Ave.
Middleton, WI 53562
Phone (608) 836-1446

National Provider Directory

National Provider Directory

Locations

6660 University Ave
Middleton, WI 53562
Phone (608) 831-6595

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1174129019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6660 UNIVERSITY AVE.",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "53562",
            "telephone_number": "608-836-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 UNIVERSITY AVE.",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "53562",
            "telephone_number": "608-836-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "MARABELLI",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "608-609-4023",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.