Individual provider Active NPI

Michael Mianecki, D.D.S.

  • Dentist
  • Chesterfield, MI
National Provider Identifier
1730237181
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12534 Issued in MI
Practice address
51190 D W Seaton Dr
Chesterfield, MI 48047-1457
Phone
(586) 725-9898
Fax
(586) 725-4470
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12534 MI Primary

Addresses

Primary practice location

51190 D W Seaton Dr
Chesterfield, MI 48047-1457

Mailing address

51190 D W Seaton Dr
Chesterfield, MI 48047-1457
Phone (586) 725-9898

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12534MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L Mianecki DDS & John P Carlino DDS PC Dentist 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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730237181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51190 D W SEATON DR",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471457",
            "telephone_number": "586-725-9898",
            "fax_number": "586-725-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51190 D W SEATON DR",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471457",
            "telephone_number": "586-725-9898",
            "fax_number": "586-725-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIANECKI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

  • 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.