Mitchell R Edlund, DDS MS PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN20067 Issued in FL

Practice address

2910 Bee Ridge Road
Sarasota, FL 34239

Phone

(941) 371-8448

Fax

(941) 924-4234

NPI assigned

Jul 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Aug 2, 2023 through Aug 2, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1043410491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 BEE RIDGE ROAD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-371-8448",
            "fax_number": "941-924-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BEE RIDGE ROAD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-371-8448",
            "fax_number": "941-924-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDLUND",
        "first_name": "MITCHELL",
        "middle_name": "R",
        "credential": "DDS MS PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DRP 547",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN20067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ecomerfordnp PLLC
• Farah Edds, MPAS, PA-C
• Nathan Conrad Eder
• Jennifer Wolf Edgson, R.N., C.C.M.
• Matthew Jonathan Edlund, MD MOH
• Bennitta Denise Edmeade, APRN
• Marc Gide Edmond
• Darren James Edmonds, D.C.
• Angela Rae Edmondson, MSN, APRN, FNP-C
• Katie Lynn Ednie, MS, CCC-SLP

• Endodontics in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.