Michael Reilly, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

39794 Issued in NY

Practice address

255 Mason Ave.
Staten Island, NY 10305-3416

Phone

(718) 987-6543

Fax

(718) 987-6542

NPI assigned

Jan 2, 2007

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 Miceli DDS PC

  • General Practice Dentistry
  • Staten Island, NY
  • NPI 1932266566
  NPD (past)
• JDS Dental Care PLLC

  • Dentist
  • Staten Island, NY
  • NPI 1922640630
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1942367578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MASON AVE.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053416",
            "telephone_number": "718-987-6543",
            "fax_number": "718-987-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MASON AVE.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053416",
            "telephone_number": "718-987-6543",
            "fax_number": "718-987-6542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "276 route 202",
            "address_purpose": "LOCATION",
            "city": "flemington",
            "state": "NJ",
            "postal_code": "08822",
            "country_code": "US",
            "telephone_number": "908-751-7055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI01925000",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "39794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Reilly
• Harold Francis Reilly Jr., M.D.
• James Gerard Reilly, D.O.
• John Patrick Reilly, MD
• Melissa T Reilly
• Michele Reilly
• Michelle Marie Reilly, OTR/L
• Patricia Marie Reilly, LCSW
• Samantha Reilly, SLP
• Tiffany Berit Reilly, LMHC

• Orthodontics and Dentofacial Orthopedics Dentistry in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.