Individual provider Active NPI

Estefania Isabel Miranda, DMD

  • Dentist
  • York, PA
National Provider Identifier
1639526643
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS040793 Issued in PA
Practice address
1623 Rodney Rd
York, PA 17408-9106
Phone
(717) 764-8541
Fax
(717) 767-5946
NPI assigned
May 19, 2016
Last updated
May 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS040793 PA Primary

Addresses

Primary practice location

1623 Rodney Rd
York, PA 17408-9106

Mailing address

1623 Rodney Rd
York, PA 17408-9106
Phone (717) 764-8541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 20, 2025 through Mar 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS040793PAMDDentist
10103SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professionals of Pennsylvania P C Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1639526643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 RODNEY RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174089106",
            "telephone_number": "717-764-8541",
            "fax_number": "717-767-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 RODNEY RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174089106",
            "telephone_number": "717-764-8541",
            "fax_number": "717-767-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ESTEFANIA",
        "middle_name": "ISABEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.