Courtney Mitchell, III DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4376 Issued in NC

Legal business name

COURTNEY MITCHELL, III DDS PA

Practice address

2500 N. Herritage St.
Suite a
Kinsten, NC 28501

Phone

(252) 522-4313

Fax

(252) 522-5777

NPI assigned

Jul 10, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Courtney Mitchell III, DDSNPI 1730521063

Title

Dentist

Phone

(252) 522-4313

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Courtney Mitchell IV, DDS

  • General Practice Dentistry
  • Kinston, NC
  • NPI 1730521063
  NPD (past) Authorized official
• Mary Lisa Sypawka Carter, DDS

  • General Practice Dentistry
  • Kinston, NC
  • NPI 1467297788
  NPD (past)

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1023459757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N HERRITAGE ST.",
            "address_2": "SUITE A",
            "city": "KINSTEN",
            "state": "NC",
            "postal_code": "28501",
            "telephone_number": "252-522-4313",
            "fax_number": "252-522-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N. HERRITAGE ST.",
            "address_2": "SUITE A",
            "city": "KINSTEN",
            "state": "NC",
            "postal_code": "28501",
            "telephone_number": "252-522-4313",
            "fax_number": "252-522-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY MITCHELL, III DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "252-522-4313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8995998",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.