Minichelli Dentistry, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS027249L Issued in PA

Legal business name

MINICHELLI DENTISTRY, INC.

Practice address

2606 Caughey Rd
Erie, PA 16506-2148

Phone

(814) 833-4393

Fax

(814) 838-0781

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Richard Minichelli, D.M.D.

Title

President

Phone

(814) 833-4393

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Michael Thomas Moore, DMD

  • Dentist
  • Erie, PA
  • NPI 1093373326
  NPD (past)
• Erin K Rose, D.M.D

  • Dentist
  • Erie, PA
  • NPI 1699033431
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275677452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 CAUGHEY RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062148",
            "telephone_number": "814-833-4393",
            "fax_number": "814-838-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 CAUGHEY RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062148",
            "telephone_number": "814-833-4393",
            "fax_number": "814-838-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINICHELLI DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MINICHELLI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-833-4393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027249L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI",
            "identifier": "608515",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindbodysoulworks, LLC
• Mindset Over Matter LLC
• Cathleen Anna Miner, PH.D.
• Deborah L. Mingey, M.D.
• John Richard Mingey, MD
• Stephen Minick, LPC
• Shannon Marie Minihane, PA-C
• Valerie Mininger
• Kenneth R Mink, MD
• Bobbi Lynn Minnick, MACCCSLP

• General Practice Dentistry in Erie, PA
• Providers in Erie, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.