Penny Mericle, D.M.D, M.S.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS025005L Issued in PA

Practice address

190 Welles St
Forty Fort, PA 18704-4968

Phone

(570) 287-8700

NPI assigned

May 23, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629071618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 WELLES ST",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044968",
            "telephone_number": "570-287-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WELLES ST",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044968",
            "telephone_number": "570-287-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERICLE",
        "first_name": "PENNY",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.S.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS025005L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Eileen Massura, M.S.
• Mary Elizabeth McCann, RD,LDN
• Gary Peter McGee, D.C.
• Danielle McGurk, BCBA
• George Mercurio
• Melissa Mikovitch, CRNP
• Julie Miller, MS., CCC-SLP
• Move2Perform LLC
• Maria E. Murphy, RD, LDN
• Charles Joseph Musto, DMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Forty Fort, PA
• Providers in Forty Fort, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.