NPIMap

Organization Active NPI

Mahoning Avenue Dental Health Center Michael Crites DDS Inc

  • General Practice Dentistry
  • Youngstown, OH
National Provider Identifier
1225447709
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30019501 Issued in OH
Legal business name
MAHONING AVENUE DENTAL HEALTH CENTER MICHAEL CRITES DDS INC
Practice address
3353 Mahoning Ave
Youngstown, OH 44509-2617
Phone
(330) 792-9600
NPI assigned
Aug 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Maggi Evans
Title
Sr. Credentialing Specialist
Phone
(720) 272-7558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30019501 OH Primary

Addresses

Primary practice location

3353 Mahoning Ave
Youngstown, OH 44509-2617

Mailing address

3353 Mahoning Ave
Youngstown, OH 44509-2617
Phone (330) 792-9600

Other names 1

  • Jamboree Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1225447709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 MAHONING AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092617",
            "telephone_number": "330-792-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 MAHONING AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092617",
            "telephone_number": "330-792-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHONING AVENUE DENTAL HEALTH CENTER MICHAEL CRITES DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-08",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MAGGI",
        "authorized_official_title_or_position": "SR. CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "720-272-7558"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30019501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamboree Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jamboree Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.