Stiven Mita, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS043124 Issued in PA

Practice address

2137 Welsh Rd # 3
Philadelphia, PA 19115-4963

Phone

(215) 464-5600

NPI assigned

May 29, 2021

Last updated

May 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Feb 10, 2022 through Feb 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Stiven Mita DMD LLC

  dba Mita Dental

  • Dental Clinic/Center
  • Philadelphia, PA
  • NPI 1043096159
  NPD Authorized official

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

{
    "created_epoch": "1622246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622246400000",
    "number": "1508432618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 WELSH RD # 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 WELSH RD # 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154963",
            "telephone_number": "215-464-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITA",
        "first_name": "STIVEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-29",
        "last_updated": "2021-05-29",
        "certification_date": "2021-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS043124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeena Mistry, MBCHB, MPH
• Kavin Dalpat Mistry, M.D.
• Nikhil Mistry
• Ronak Mistry, D.O.
• Leia Joelle Mita, CRNP
• Donna Jean Mitcham, CRNP
• Elana Beth Mitchel, MD
• Mitchell Psychological Services Inc
• Albert B. Mitchell, D.D.S.
• Alexa Kimberly Mitchell

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, 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 May 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.