Individual provider Active NPI

John F Mercurio Jr., DDS

  • General Practice Dentistry
  • Lindenhurst, NY
National Provider Identifier
1710998158
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33898 Issued in NY
Practice address
191 West Hoffman Ave
Lindenhurst, NY 11757-4036
Phone
(631) 226-2333
Fax
(631) 226-2386
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33898 NY Primary

Addresses

Primary practice location

191 West Hoffman Ave
Lindenhurst, NY 11757-4036

Mailing address

191 West Hoffman Ave
Lindenhurst, NY 11757-4036
Phone (631) 226-2333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33898NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lindenhurst Dental Associates General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1710998158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 WEST HOFFMAN AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574036",
            "telephone_number": "631-226-2333",
            "fax_number": "631-226-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 WEST HOFFMAN AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574036",
            "telephone_number": "631-226-2333",
            "fax_number": "631-226-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCURIO",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "33898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.