Individual provider Active NPI

Michelle Anne Flanigan, D.M.D.

  • Pediatric Dentistry
  • Staten Island, NY
National Provider Identifier
1619905346
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
051600 Issued in NY
Practice address
195 Bridgetown St
Staten Island, NY 10314-6006
Phone
(718) 761-7316
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 051600 NY Primary

Addresses

Primary practice location

195 Bridgetown St
Staten Island, NY 10314-6006

Mailing address

730 Stafford Ave
Staten Island, NY 10309-2440
Phone (347) 204-0848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251121003160 NY Practitioner - Dentist 4486146958

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051600NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
White Hall Dental, PC Pediatric Dentistry CurrentSince Sep 5, 2025 Accepting new patients
Staten Island Pediatric Dentistry Pediatric Dentistry Past Accepting new patients

Locations

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Interoperability endpoints

  • Direct secure messaging: mflanigan51477@northwell.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619905346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092440",
            "telephone_number": "347-204-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 BRIDGETOWN ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146006",
            "telephone_number": "718-761-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "MICHELLE",
        "middle_name": "ANNE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "051600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.