Individual provider Active NPI

Jeffrey Dean Mitchell, D.D.S.

  • Dentist
  • Casa Grande, AZ
National Provider Identifier
1174721708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7297 Issued in AZ
Practice address
721 N Olive Ave
Casa Grande, AZ 85222-4034
Phone
(520) 836-7111
NPI assigned
Jul 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7297 AZ Primary

Addresses

Primary practice location

721 N Olive Ave
Casa Grande, AZ 85222-4034

Mailing address

276 W Tahiti Dr
Casa Grande, AZ 85222
Phone (520) 413-7760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7297AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell and Crosby Dental PLLC Dentist Current Accepting new patients

Locations

721 N Olive Ave
Casa Grande, AZ 85122
Phone (520) 836-7111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174721708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 W TAHITI DR",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85222",
            "telephone_number": "520-413-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N OLIVE AVE",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "852224034",
            "telephone_number": "520-836-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JEFFREY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "7297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.