Individual provider Active NPI

Mitchell Hines, DDS

  • General Practice Dentistry
  • Garner, NC
National Provider Identifier
1235807520
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12445 Issued in NC
Practice address
12450 Cleveland Rd Ste 100
Garner, NC 27529-8355
Phone
(919) 772-9927
NPI assigned
Sep 1, 2021
Last updated
Sep 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12445 NC Primary

Addresses

Primary practice location

12450 Cleveland Rd Ste 100
Garner, NC 27529-8355

Mailing address

4035 Pine Arch Way
New Hill, NC 27562-9623
Phone (919) 816-5741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922000692 NC Order and Referring Only - DentistPractitioner - Dentist 5092112839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lane & Associates DDS Xvii PA General Practice CurrentSince Jul 24, 2022 Accepting new patients

Locations

12450 Cleveland School Rd
Ste 100
Garner, NC 27529
Phone (919) 639-2020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1235807520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 PINE ARCH WAY",
            "city": "NEW HILL",
            "state": "NC",
            "postal_code": "275629623",
            "telephone_number": "919-816-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 CLEVELAND RD STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275298355",
            "telephone_number": "919-772-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "MITCHELL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.