NPIMap

Organization Active NPI

Mitchell Oral Surgery and Implant Centers PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Clearwater, FL
National Provider Identifier
1003287129
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN10802 Issued in FL
Legal business name
MITCHELL ORAL SURGERY AND IMPLANT CENTERS PA
Practice address
2535 Landmark Dr Ste 105
Clearwater, FL 33761-3930
Phone
(727) 791-6529
NPI assigned
Oct 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark Wayne Mitchell, D.D.SNPI 1386634343
Title
Owner
Phone
(727) 842-5180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DN10802 FL Primary

Addresses

Primary practice location

2535 Landmark Dr Ste 105
Clearwater, FL 33761-3930

Mailing address

6731 Madison St
New Port Richey, FL 34652-1928
Phone (727) 842-5180

Other names 1

  • MOSAIC Doing business as

National Provider Directory

National Provider Directory

Locations

2535 Landmark Dr
Ste 105
Clearwater, FL 33761
Phone (727) 791-6529

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1003287129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6731 MADISON ST",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346521928",
            "telephone_number": "727-842-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 LANDMARK DR STE 105",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613930",
            "telephone_number": "727-791-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL ORAL SURGERY AND IMPLANT CENTERS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-842-5180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN10802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOSAIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.