Individual provider Active NPI

Edward Mereminsky, D.M.D.

  • Dentist
  • Levittown, PA
National Provider Identifier
1417008996
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS036428 Issued in PA
Practice address
35 Stonybrook Dr
Levittown, PA 19055-2216
Phone
(215) 946-7171
NPI assigned
Jan 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS036428 PA Primary
Dentist 122300000X 22DI02303400 NJ

Addresses

Primary practice location

35 Stonybrook Dr
Levittown, PA 19055-2216

Mailing address

11064 Greiner PL
Philadelphia, PA 19116-2610
Phone (215) 464-7940

Other identifiers 1

IdentifierTypeStateIssuer
972541OtherPAUNITED CONCORDIA OFFICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160503000315 NJ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8022317650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02303400NJMDDentist
DS036428PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stonybrook Dental Assoc. Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417008996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11064 GREINER PL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162610",
            "telephone_number": "215-464-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 STONYBROOK DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190552216",
            "telephone_number": "215-946-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREMINSKY",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS036428",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02303400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA OFFICE",
            "identifier": "972541",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, PA

Sources for this page

Verify at the official NPI Registry.