Midland Family Dental Care,PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19162 Issued in NJ

Legal business name

MIDLAND FAMILY DENTAL CARE,PA

Practice address

765 Midland Ave
Garfield, NJ 07026-2100

Phone

(973) 340-4484

Fax

(973) 340-2282

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fred Anthony Puccio, DDSNPI 1114038460

Title

President

Phone

(973) 340-4484

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fred Anthony Puccio, DDS

  • General Practice Dentistry
  • Garfield, NJ
  • NPI 1114038460
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891806147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 MIDLAND AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070262100",
            "telephone_number": "973-340-4484",
            "fax_number": "973-340-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 MIDLAND AVE",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070262100",
            "telephone_number": "973-340-4484",
            "fax_number": "973-340-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND FAMILY DENTAL CARE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUCCIO",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-340-4484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Mariniello, DC
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• Afua Mensah, RN
• Mercedes & Family
• Mercedes and Family LLC (Mercedes and Family LLC IOP)
• Kristina J Miers
• Joseph D. Migliaccio, D.P.M.
• Nicole Molyneaux, DC
• Melina Morel, LBA
• Yousuf Munnan-Urrehman, BPHARM

• General Practice Dentistry in Garfield, NJ
• Providers in Garfield, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.