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MARINE DENTAL SERVICES
NPI 1932266566
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: August 02, 2026.

About Marine Dental Services NPPES

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

MARINE DENTAL SERVICES (NPI 1932266566) is a healthcare organization registered as a general practice in Staten Island, New York and active in the NPI registry since January 2007. The organization lists Jack Miceli, President, as its authorized official.

NPPES Registry Identity

NPI1932266566
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameJACK MICELI DDS PC
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
Organization SubpartYesParent: Marine Dental Services
Authorized OfficialJack MiceliPresident · (718) 987-6543
Enumeration DateJanuary 2, 2007
Last NPPES UpdateFebruary 23, 2010
✔ NPI 1932266566 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 Names 1

Doing Business AsMarine Dental Services

Other Identifiers 1

Medicaid02353280NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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. VINCENT AUGELLO DDS
Dentist (General Practice)
255 MASON AVE.
STATEN ISLAND, NY 10305
Richmond County (718) 987-6543
MR. JACK MICELI DDS
Dentist (General Practice)
255 MASON AVE.
STATEN ISLAND, NY 10305
Richmond County (718) 987-6543
MR. JOHN FOPPIANI DDS
Dentist (Periodontics)
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 Dds PC's NPI number?

The NPI number for Jack Miceli Dds PC is 1932266566. It was assigned to this organization in the NPPES registry on January 2, 2007. The provider is doing business as Marine Dental Services.

Where is Jack Miceli Dds PC located?

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

What is Jack Miceli Dds PC's specialty?

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

When was this NPI record last updated?

The NPPES record for Jack Miceli Dds PC was last updated on February 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.