Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jack Miceli, DDS

Individual provider General Practice Dentistry · NPI 1851458483

Mr. Jack Miceli, DDS is a General Practice Dentistry in Staten Island, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

255 Mason Ave
Staten Island, NY 10305-3416
Phone: (718) 987-6543
Fax: (718) 987-6542
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 39067 (NY)

Record details

NPI number1851458483
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJanuary 2, 2007
Last updated in NPPESFebruary 23, 2010
Mailing address255 Mason Ave., Staten Island, NY 10305-3416

Other providers in Staten Island