John Michael Marincel, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019031406 Issued in IL

Practice address

2800 College Ave
Alton, IL 62002-4742

Phone

(618) 474-7000

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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.

• Jack M. Marincel, D.D.S., P.C.

  • Dental Clinic/Center
  • Saint Louis, MO
  • NPI 1780797308
  NPD (past) Authorized official
• Southern Illinois University Edwardsville School of Dental Medicine

  • General Practice Dentistry
  • Alton, IL
  • NPI 1215912696
  NPD (past)
• Southern Illinois University Edwardsville School of Dental Medicine

  • Dentist
  • E St Louis, IL
  • NPI 1760467146
  NPD (past)
• Fresh Smiles, LLC

  • Dental Clinic/Center
  • Saint Louis, MO
  • NPI 1376061028
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1851474803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024742",
            "telephone_number": "618-474-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024742",
            "telephone_number": "618-474-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINCEL",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "13331",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick William Malone, DMD
• Megha Bharat Manek, MD
• Drew Henry Maness, RN
• Angela Mangi
• Mario J Marcinczyk, MD
• Mark D. Wade O D P C
• Shelby Ann Markel, MD
• Stacy R Marriott, APRN, CNP
• Dena Marshall, PT
• Brianna Martin

• Dentist in Alton, IL
• Providers in Alton, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.