Individual provider Active NPI

Mikaylie Parco, DDS

  • Dentist
  • Jefferson City, MO
National Provider Identifier
1124952981
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2026025503 Issued in MO
Practice address
1511 Christy Dr
Jefferson City, MO 65101-2854
Phone
(573) 632-2777
NPI assigned
Jun 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2026025503 MO Primary

Addresses

Primary practice location

1511 Christy Dr
Jefferson City, MO 65101-2854

Mailing address

1402 E High St
Jefferson City, MO 65101-4825
Phone (816) 500-0074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

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": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1124952981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 E HIGH ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651014825",
            "telephone_number": "816-500-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 CHRISTY DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012854",
            "telephone_number": "573-632-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARCO",
        "first_name": "MIKAYLIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2026025503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.