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MR. JACK MICELI DDS
NPI 1851458483
Dentist - General Practice in Staten Island, NY

Active since January 02, 2007
255 MASON AVE., STATEN ISLAND, NY 10305(718) 987-6543(718) 987-6542 Get Directions Write a Review

NPPES record last updated: February 23, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Jack Miceli Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACK MICELI DDS (NPI 1851458483) is an individual general practice provider in Staten Island, New York, licensed in New York (39067) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1851458483
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameMR. JACK MICELICredential: DDS
Location Address255 MASON AVE.Staten Island, NY 10305-3416
Mailing Address255 Mason Ave.Staten Island, NY 10305-3416 · (718) 987-6543 · Fax (718) 987-6542
Phone(718) 987-6543
Fax(718) 987-6542
Sole ProprietorNo
Enumeration DateJanuary 2, 2007
Last NPPES UpdateFebruary 23, 2010
✔ NPI 1851458483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 39067
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

255 MASON AVE., Staten Island, NY 10305
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Other Identifiers 1

Medicaid02241885NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JOHN FOPPIANI DDS
Dentist (Periodontics)
255 MASON AVE.
STATEN ISLAND, NY 10305
Richmond County (718) 987-6543
MR. VINCENT AUGELLO DDS
Dentist (General Practice)
255 MASON AVE.
STATEN ISLAND, NY 10305
Richmond County (718) 987-6543
JACK MICELI DDS PC
Dentist (General Practice)
255 MASON AVE.
STATEN ISLAND, NY 10305
Richmond County (718) 987-6543
MR. MICHAEL REILLY DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
255 MASON AVE.
STATEN ISLAND, NY 10305
Richmond County (718) 987-6543

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Miceli's NPI number?

The NPI number for Jack Miceli is 1851458483. It was assigned to this individual provider in the NPPES registry on January 2, 2007.

Where is Jack Miceli located?

Jack Miceli practices at 255 Mason Ave., Staten Island, NY 10305. The listed phone number is (718) 987-6543.

What is Jack Miceli's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Jack Miceli accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, HRI Dental & Vision and Humana and 1 other insurer list Jack Miceli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Miceli was last updated on February 23, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.