Thomas Michael Persico, D.M.D.

Individual provider Active NPI General Practice Dentistry · Monessen, PA

NPI 1912978271 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1912978271
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS018597L (PA)
Practice address
15 Eastgate
Monessen, PA 15062-1387
Phone
(724) 684-4020
Fax
(724) 684-6406
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DS018597LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cicchini Dental, LLC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS018597L PA Yes

Addresses

Primary practice location

15 Eastgate
Monessen, PA 15062-1387

Mailing address

1323 Rostraver St
Monessen, PA 15062-1901
Phone (724) 684-4435

Other providers in Monessen, PA

All providers in Monessen, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.