Alexis Brooke Michelman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052486 Issued in NY

Practice address

656 N Wellwood Ave
Lindenhurst, NY 11757-1695

Phone

(631) 225-1010

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277596800000",
    "number": "1972649721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WILTSHIRE RD",
            "address_2": "APT D-13",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834559",
            "telephone_number": "631-431-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 N WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571695",
            "telephone_number": "631-225-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELMAN",
        "first_name": "ALEXIS",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2010-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John F Mercurio Jr., DDS
• Jeanne Meteles, LMSW
• Katherine Meyer, RN
• Mi Patito LLC (Cohen's Fashion Optical)
• Michele Marie Mianulli, LPN
• Mikayla J Altintas
• Jennifer Y Milano, MA CCCA
• Sileni Maria Milanovic
• Joanne Milito, LCSW
• Leslie Diane Miller, M.S.ED.

• General Practice Dentistry in Lindenhurst, NY
• Providers in Lindenhurst, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.