Mitchell Indictor, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN-0009635 Issued in FL

Practice address

207 SE 23Rd Ave
Suite 100
Boynton Beach, FL 33435-7653

Phone

(561) 734-8600

Fax

(561) 738-6652

NPI assigned

Jan 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Jul 1, 2015 through Jul 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Mitchell Indictor, D.D.S., P.a.

  • General Practice Dentistry
  • Boynton Beach, FL
  • NPI 1699085498
  NPD (past) Authorized official
• East Boynton Dentistry LLC

  • Dentist
  • Boynton Beach, FL
  • NPI 1215739255
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245385525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SE 23RD AVE",
            "address_2": "SUITE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357653",
            "telephone_number": "561-734-8600",
            "fax_number": "561-738-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 SE 23RD AVE",
            "address_2": "SUITE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357653",
            "telephone_number": "561-734-8600",
            "fax_number": "561-738-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDICTOR",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN-0009635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kathryn Incledon, RD, LDN, MS
• James Daren Incledon, D.C.
• Steven Dennis Incledon, DC
• Angelo Nicholas Incorvaia, M.D.
• Jacilyn Indellicati
• Indigo Light Health, Inc.
• Infinite Integrity Health Center LLC
• Infinity Health Services, Inc. (Activa Home Health)
• Charles Ingram, MD
• Injury Treatment Center of Boynton Beach Inc (Choice Medical Center)

• General Practice Dentistry in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• General Practice Dentistry in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.