Barry Allem Mentzel, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

100005 Issued in MI

Practice address

19925 E 10 Mile Rd
St Clair Shores, MI 48080-1069

Phone

(586) 772-1880

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

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 22, 2014 through Mar 22, 2028

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.

• Barry a. Mentzel, D.D.S., P.C.

  • Periodontics
  • Saint Clair Shores, MI
  • NPI 1700053634
  NPD (past) Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659319218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19925 E 10 MILE RD",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801069",
            "telephone_number": "586-772-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19925 E 10 MILE RD",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801069",
            "telephone_number": "586-772-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTZEL",
        "first_name": "BARRY",
        "middle_name": "ALLEM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "100005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aston Mehr
• Kenneth J Meisel, LMSW
• Maria Amelia Menozzi, LMFT, CAADC
• Mental Mix Therapy PLLC
• Mental Wellness Restored
• Jose A Mercado-Francis, MD
• Kimberly Merkle
• Demetrios Mermiges, M.D.
• Jamie Megan Merrick, OTRL
• Maria Vicenta Merritt, LMSW, ACSW

• Periodontics in St Clair Shores, MI
• Providers in St Clair Shores, MI by specialty
• Periodontics in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.