Mitchell S Parker, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5366 Issued in TN

Practice address

1461 Munford Ave
Munford, TN 38058

Phone

(901) 837-6868

Fax

(901) 837-4776

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Southern Dental of Munford PLLC

  • General Practice Dentistry
  • Munford, TN
  • NPI 1558814178
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215010442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 130",
            "address_2": "MUNFORD AVE",
            "city": "MUNFORD",
            "state": "TN",
            "postal_code": "38058",
            "telephone_number": "901-837-6868",
            "fax_number": "901-837-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 MUNFORD AVE",
            "city": "MUNFORD",
            "state": "TN",
            "postal_code": "38058",
            "telephone_number": "901-837-6868",
            "fax_number": "901-837-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MITCHELL",
        "middle_name": "S",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "5366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Pugh Millican, FNP
• Robert Moody, PAC
• John R Nichols, DDS
• Mary Nobert
• Alexander Wayne Parham, DC
• Kavin Mahesh Patel
• Miral Patel
• Lauren Poston, DC
• Thomas Douglas Purcell
• Brandi Reed, LMT, MMP, CLDT,

• General Practice Dentistry in Munford, TN
• Providers in Munford, TN by specialty
• General Practice Dentistry in Tennessee

• 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.