NPIMap

Organization Active NPI

Mitchell Bridge Dental II

  • Dental Clinic/Center
  • Athens, GA
National Provider Identifier
1083850150
Registry record updated Dec 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN010077 Issued in GA
Legal business name
MITCHELL BRIDGE DENTAL II
Practice address
1171 Mitchell Bridge Rd Ste a
Athens, GA 30606-6475
Phone
(706) 548-2651
Fax
(706) 543-1052
NPI assigned
Dec 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2008

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

Authorized official

Name
Dr. Melody Higginbotham, DMDNPI 1710916085
Title
Dr
Phone
(706) 548-2651

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN010077 GA Primary
Dental Clinic/Center 261QD0000X DN012547 GA

Addresses

Primary practice location

1171 Mitchell Bridge Rd Ste a
Athens, GA 30606-6475

Mailing address

1171 Mitchell Bridge Rd Ste a
Athens, GA 30606-6475
Phone (706) 548-2651

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229644800000",
    "number": "1083850150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 MITCHELL BRIDGE RD STE A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066475",
            "telephone_number": "706-548-2651",
            "fax_number": "706-543-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 MITCHELL BRIDGE RD STE A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066475",
            "telephone_number": "706-548-2651",
            "fax_number": "706-543-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL BRIDGE DENTAL II",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2008-12-19",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "706-548-2651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN010077",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN012547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.