Michael Leonard Pacifico, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

021434 Issued in PA

Practice address

48 N 3Rd St
Bangor, PA 18013-1908

Phone

(610) 588-2722

Fax

(610) 599-1034

NPI assigned

Apr 25, 2007

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

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.

• Pacifico Dental Care LLC

  • Dentist
  • Bangor, PA
  • NPI 1316338205
  NPD (past) Authorized official
• Hill Oral Surgery PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Easton, PA
  • NPI 1821753021
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669691697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 N 3RD ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131908",
            "telephone_number": "610-588-2722",
            "fax_number": "610-599-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 N 3RD ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131908",
            "telephone_number": "610-588-2722",
            "fax_number": "610-599-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIFICO",
        "first_name": "MICHAEL",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "021434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak HRC Slate Belt LLC
• One Day Bath Inc.
• Abigail Bess Oxford, ATR-BC, LPC
• Pacifico Dental Care LLC
• Lauren Pacifico
• Karen Paciotti, OTR
• Pennsylvania CVS Pharmacy, L.L.C.
• Cheralyn Suzanne Perkins, DPM
• Sheniqua Plant Mitchell, MSW
• Karen Elizabeth Radzierez, PHARMD

• General Practice Dentistry in Bangor, PA
• Providers in Bangor, PA by specialty
• General Practice 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.