Dennis R Mirra, OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DENNIS R MIRRA, OD PA

Practice address

2601 Annand Dr
Suite 21
Wilmington, DE 19808-3719

Phone

(302) 998-3332

Fax

(302) 998-4828

NPI assigned

Aug 5, 2008

Last updated

Mar 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dennis Mirra, OD

Title

Owner

Phone

(302) 998-3332

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1609032085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "SUITE 21",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-998-3332",
            "fax_number": "302-998-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "SUITE 21",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-998-3332",
            "fax_number": "302-998-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS R MIRRA, OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "MIRRA",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-998-3332",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DE BLUE CROSS",
            "identifier": "B86041",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Optometrist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.