Candice Mitich, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

10177 Issued in WI

Practice address

3900 W Brown Deer Rd Ste a
Brown Deer, WI 53209-1220

Phone

(612) 568-4298

NPI assigned

Nov 8, 2017

Last updated

Nov 8, 2017By the provider in NPPES

Sex

Female

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.

• Dentamed Healthcare LLC

  • Dental Clinic/Center
  • Brown Deer, WI
  • NPI 1851832943
  NPD (past)

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1245743632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD STE A",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD STE A",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220",
            "telephone_number": "612-568-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITICH",
        "first_name": "CANDICE",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "10177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Miller
• Joan L Miller, MSW LCSW
• Jodi J Miller, PTA
• Mindstar Residential Community
• Alexis Mitchell, MSN, APNP, PMHNP-BC
• Lindsay Mitz
• Mobile Care NP, LLC
• Kayla Moe
• Jenna Mohelnitzky, LCSW
• Monarch Supportive Services LLC

• Dental Hygienist in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Dental Hygienist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.