Active NPI
Mitchell Thai
- General Practice Dentistry
- Columbus, OH
National Provider Identifier
1013750413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- RES.004822
- Practice address
- 305 W 12TH Ave
Columbus, OH 43210-1267 - Phone
- (614) 292-4468
- NPI assigned
- Jun 14, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | RES.004822 | OH | Primary |
Addresses
Primary practice location
305 W 12TH Ave
Columbus, OH 43210-1267
Mailing address
6153 Glenworth CT
Galloway, OH 43119-8559
Phone (614) 975-5405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240801004457 | OH | Order and Referring Only - Dentist | 0648717181 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1013750413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6153 GLENWORTH CT",
"city": "GALLOWAY",
"state": "OH",
"postal_code": "431198559",
"telephone_number": "614-975-5405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 W 12TH AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432101267",
"telephone_number": "614-292-4468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAI",
"first_name": "MITCHELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-14",
"last_updated": "2024-06-14",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "RES.004822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.