Active NPI
Roy L Mitchell, DDS
- General Practice Dentistry
- Oxon Hill, MD
National Provider Identifier
1326227984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 04701
- Practice address
- 6188 Oxon Hill
810
Oxon Hill, MD 20745 - Phone
- (301) 567-9150
- Fax
- (301) 567-9152
- NPI assigned
- Oct 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 04701 | MD | Primary |
Addresses
Primary practice location
6188 Oxon Hill
810
Oxon Hill, MD 20745
Mailing address
6188 Oxon Hill Rd
810
Oxon Hill, MD 20745-3113
Phone (301) 567-9150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160506001392 | MD | Order and Referring Only - Dentist | 4486953882 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04701 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1326227984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6188 OXON HILL RD",
"address_2": "810",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207453113",
"telephone_number": "301-567-9150",
"fax_number": "301-567-9152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6188 OXON HILL",
"address_2": "810",
"city": "OXON HILL",
"state": "MD",
"postal_code": "20745",
"telephone_number": "301-567-9150",
"fax_number": "301-567-9152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "ROY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-31",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "04701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxon Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.