DR. MICHAEL CHARLES MISTRETTA D.D.S. M.D. NPI 1780602920

NPI Information

  • NPI: 1780602920
  • Provider Name: DR. MICHAEL CHARLES MISTRETTA, D.D.S., M.D.
  • Classification: Oral & Maxillofacial Surgery - 204E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 CENTRAL PARK S
    SUITE 105
    NEW YORK, NY
    ZIP 10019
  • Phone: (212) 245-3292

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NPI Details

DR. Michael Charles Mistretta, D.D.S., M.D. is an oral maxillofacial surgery in New York, NY. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. DR. Michael Charles Mistretta, D.D.S., M.D. NPI is 1780602920. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 CENTRAL PARK S
SUITE 105
NEW YORK, NY
ZIP 10019-436
Phone: (212) 245-3292
Fax: (212) 245-8758

The NPI 1780602920 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/17/2006 and was last updated on 4/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery049087-1NEW YORKNo
2204E00000XOral & Maxillofacial Surgery240428-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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