Charles J Mistretta, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

031340 Issued in NY

Practice address

1911 Richmond Ave
Suite 215
Staten Island, NY 10314-3913

Phone

(718) 370-1911

NPI assigned

Oct 25, 2006

Sex

Male

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

Specialty

Dentist

Education

New York University College of Dentistry, 1975

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• White Hall Dental, PC

  • Dentist
  • New Hyde Park, NY
  • NPI 1376268821
  NPD

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": "1982789681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 RICHMOND AVE",
            "address_2": "SUITE 215",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143913",
            "telephone_number": "718-370-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 RICHMOND AVE",
            "address_2": "SUITE 215",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143913",
            "telephone_number": "718-370-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "031340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Missak, D.O.
• Brittany Anne Misseri
• Mission of the Immaculate
• Mission of the Immaculate Virgin
• Mission of the Immaculate Virgin
• Jaclyn Mistretta, LCSW
• Mitchell a. Schuman, MD,PC
• Catherine Mitchell, OTR/L
• Janet Mitchell
• Linda Mitchell, M.S., CCC-SLP

• General Practice Dentistry in Staten Island, NY
• Providers in Staten Island, 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 Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.