Mitchell David Billes, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN015565 Issued in GA

Practice address

10104 Ford Ave Ste G
Richmond Hill, GA 31324-8849

Phone

(912) 445-5337

Fax

(734) 421-5221

NPI assigned

Mar 23, 2006

Last updated

Oct 7, 2019By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1306806526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10104 FORD AVE STE G",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248849",
            "telephone_number": "912-445-5337",
            "fax_number": "888-289-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10104 FORD AVE STE G",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248849",
            "telephone_number": "912-445-5337",
            "fax_number": "734-421-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Vilseck Road Bldg 419-2",
            "address_purpose": "LOCATION",
            "city": "Ft. Stewart",
            "state": "GA",
            "postal_code": "31315",
            "country_code": "US",
            "telephone_number": "912-257-7056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILLES",
        "first_name": "MITCHELL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "14384",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1306806526",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.