Individual provider Active NPI

Andrew Edward Mikhail, D.M.D.

  • Dentist
  • Tampa, FL
National Provider Identifier
1295195543
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22056 Issued in FL
Practice address
12113 W Linebaugh Ave
Tampa, FL 33626-1732
Phone
(813) 586-4682
NPI assigned
Feb 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22056 FL Primary

Addresses

Primary practice location

12113 W Linebaugh Ave
Tampa, FL 33626-1732

Mailing address

12113 W Linebaugh Ave
Tampa, FL 33626-1732
Phone (813) 586-4682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170929000673 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880969922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22056FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1295195543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12113 W LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261732",
            "telephone_number": "813-586-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12113 W LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261732",
            "telephone_number": "813-586-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "ANDREW",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "22056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.