Active NPI
Michael P Cellitti, DDS
- Pediatric Dentistry
- Saint Paul, MN
National Provider Identifier
1194792986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- A8047
- Practice address
- 411 Main St
Suite 400
Saint Paul, MN 55102-1080 - Phone
- (651) 224-4969
- Fax
- (651) 223-8047
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | A8047 | MN | Primary |
Addresses
Primary practice location
411 Main St
Suite 400
Saint Paul, MN 55102-1080
Mailing address
411 Main St
Suite 400
Saint Paul, MN 55102-1080
Phone (651) 224-4969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A8047 | MN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1194792986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 MAIN ST",
"address_2": "SUITE 400",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551021080",
"telephone_number": "651-224-4969",
"fax_number": "651-223-8047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 MAIN ST",
"address_2": "SUITE 400",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551021080",
"telephone_number": "651-224-4969",
"fax_number": "651-223-8047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CELLITTI",
"first_name": "MICHAEL",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MN",
"license": "A8047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
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Sources for this page
- 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.