Individual provider Active NPI

Michael P Mendelson, DDSFAGD

  • General Practice Dentistry
  • Mechanicsburg, PA
National Provider Identifier
1881778744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS020930L Issued in PA
Practice address
4824 E Trindle Rd
Mechanicsburg, PA 17050-3617
Phone
(717) 761-8056
Fax
(717) 975-3539
NPI assigned
Oct 25, 2006
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
General Practice Dentistry 1223G0001X DS020930L PA Primary

Addresses

Primary practice location

4824 E Trindle Rd
Mechanicsburg, PA 17050-3617

Mailing address

4824 E Trindle Rd
Mechanicsburg, PA 17050-3617
Phone (717) 761-8056

Other identifiers 2

IdentifierTypeStateIssuer
450208OtherPAUNITED CONCORDIA PROVIDER
95793OtherPAUNITED CONCORDIA PROVIDER

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
DS020930LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelson, Foer, Harrison Dental Associates General Practice Past Accepting new patients
Dental Professionals of Pennsylvania P C General Practice Past Accepting new patients

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881778744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E TRINDLE RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503617",
            "telephone_number": "717-761-8056",
            "fax_number": "717-975-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E TRINDLE RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503617",
            "telephone_number": "717-761-8056",
            "fax_number": "717-975-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELSON",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDSFAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS020930L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "450208",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "95793",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

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.