Organization Active NPI

William D. Mestichelli D.D.S., P.C.

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1619368933
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS022834L Issued in PA
Legal business name
WILLIAM D. MESTICHELLI D.D.S., P.C.
Practice address
1903 S Broad St
Philadelphia, PA 19148-2216
Phone
(215) 334-2000
Fax
(215) 755-7333
NPI assigned
Feb 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Authorized official

Name
Dr. William Mestichelli, D.D.S.
Title
Owner
Phone
(215) 334-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS022834L PA Primary

Addresses

Primary practice location

1903 S Broad St
Philadelphia, PA 19148-2216

Mailing address

1903 S Broad St
Philadelphia, PA 19148-2216
Phone (215) 334-2000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1619368933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482216",
            "telephone_number": "215-334-2000",
            "fax_number": "215-755-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482216",
            "telephone_number": "215-334-2000",
            "fax_number": "215-755-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM D. MESTICHELLI D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "MESTICHELLI",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-334-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS022834L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.