Stephanie Marvelli, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11166 Issued in NC

Practice address

11300 Cresthill Dr.
Suite 105
Mint Hill, NC 28227

Phone

(704) 323-7577

NPI assigned

Jun 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Stephanie Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mint Hill Smiles

  • General Practice Dentistry
  • Mint Hill, NC
  • NPI 1518426006
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1619359247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 KENILWORTH AVE.",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28203",
            "telephone_number": "734-232-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 CRESTHILL DR.",
            "address_2": "SUITE 105",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "28227",
            "telephone_number": "704-323-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVELLI",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021566",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "JOHNSON",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mateen Oliver Manshadi, MD
• Ericka Sherrell Martin
• Jane Martin, PTA
• Sarahann Lauzon Martin
• Tahiyya Martin
• Gretel Stephanie Maya Farfan, LCMHC ASSOCIATE
• Kimberly McAllister, M.S. CCC-SLP, CDP
• Jakeema McCloud, PHARMD
• Ryan McFarland, PT
• McLaren DDS Mint Hill PLLC

• General Practice Dentistry in Mint Hill, NC
• Providers in Mint Hill, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.