Joseph D Miceli, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4887 Issued in CT

Practice address

106 Noroton Ave
Middlesex Dental Group PC
Darien, CT 06820-5237

Phone

(203) 655-9922

Fax

(203) 655-9597

NPI assigned

Apr 17, 2007

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

Other identifiers 1

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 Dec 30, 2015 through Dec 30, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558586164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 NOROTON AVE",
            "address_2": "MIDDLESEX DENTAL GROUP PC",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068205237",
            "telephone_number": "203-655-9922",
            "fax_number": "203-655-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 NOROTON AVE",
            "address_2": "MIDDLESEX DENTAL GROUP PC",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068205237",
            "telephone_number": "203-655-9922",
            "fax_number": "203-655-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "JOSEPH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "4887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "020004887CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian P McKay, DC
• Medi Oasis Health Services
• Melanie Sorensen, LCSW, LLC
• Kelly Anne Melchionno, NP-C
• Erin Patricia Micali, PSY.D.
• Michele D. Brown, M.D., LLC (Michele D Brown, MD)
• Kyle Michelson, OTR/L
• Middlesex Dental Group PC
• Ashleigh E. Miller, LCSW
• Charles Miner III, M.D.

• Dentist in Darien, CT
• Providers in Darien, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.