Kendall Ann Mitchell, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9769 Issued in NC

Practice address

101 Stevens Memorial PL
Goldsboro, NC 27534-2372

Phone

(919) 736-4830

Fax

(919) 736-7030

NPI assigned

Jun 4, 2014

Last updated

Mar 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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 NC

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

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1003229493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 STEVENS MEMORIAL PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342372",
            "telephone_number": "919-736-4830",
            "fax_number": "919-736-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STEVENS MEMORIAL PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342372",
            "telephone_number": "919-736-4830",
            "fax_number": "919-736-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KENDALL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara A Minton-Merkwa
• Theresa Mae S Misperos, CADC-R
• Mitchell Eye Center DRS. Mitchell, Mitchell & Assoc, Optometrists P.a. (Mitchell Eye Center)
• Frank Bradley Mitchell, DDS PA
• Freddie Lamont Mitchell, OD
• Laura Mitchell
• William Earl Mitchell, OD
• Megan Moeller, L.P.C.
• Aminu Isyaku Mohammed, M.D.
• Monarch

• General Practice Dentistry in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.