Mitchell Mamorsky, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

060186 Issued in NY

Practice address

6863 108TH St
Forest Hills, NY 11375-2975

Phone

(718) 575-1010

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1396272191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 4TH AVE APT 4E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6863 108TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752975",
            "telephone_number": "718-575-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMORSKY",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "060186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anando Kumar Malo, MD
• Cassandra Theresa Malouta, MA
• Mama Program LLC
• Michelle Mamann
• Vyacheslav Mamanov, NP
• Gisela Mamposo, LCSW-R
• Shreya Mandal, JD LCSW
• Mollie Malka Mandel, NP
• Dominique Manfreda
• Steven Joseph Manierre, D.O.

• Oral and Maxillofacial Surgery (Dentist) in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.