Active NPI
Ron Micchia
- Dentist
- Mentor, OH
National Provider Identifier
1497177646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15919
- Practice address
- 9140 Lakeshore Blvd
Mentor, OH 44060 - Phone
- (440) 257-3900
- NPI assigned
- Jan 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 15919 | OH | Primary |
Addresses
Primary practice location
9140 Lakeshore Blvd
Mentor, OH 44060
Mailing address
9140 Lake Shore Blvd
Mentor, OH 44060-1637
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 |
|---|---|---|---|
| 15919 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mentor Dental Arts Ronald L. Micchia DDS, Inc. | Past | Accepting new patients | |
| William E Mitman DDS and Assoc Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Mentor, OH
- NPI 1578640066
-
- General Practice Dentistry
- Mentor, OH
- NPI 1790859387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389052800000",
"number": "1497177646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9140 LAKE SHORE BLVD",
"city": "MENTOR",
"state": "OH",
"postal_code": "440601637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9140 LAKESHORE BLVD",
"city": "MENTOR",
"state": "OH",
"postal_code": "44060",
"telephone_number": "440-257-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICCHIA",
"first_name": "RON",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-07",
"last_updated": "2014-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "15919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.