Walter D Mick, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18530 Issued in OH

Practice address

1561 Brice Rd
Reynoldsburg, OH 43068-2701

Phone

(614) 864-4618

Fax

(614) 860-9225

NPI assigned

Dec 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in OH

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

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.

• Walter D Mick DDS Inc

  dba Mick Family Dental Care

  • General Practice Dentistry
  • Reynoldsburg, OH
  • NPI 1932119245
  NPD (past) Authorized official
• East Columbus Family Dental Care LLC

  • General Practice Dentistry
  • Reynoldsburg, OH
  • NPI 1386481810
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447311329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 BRICE RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682701",
            "telephone_number": "614-864-4618",
            "fax_number": "614-860-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 BRICE RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682701",
            "telephone_number": "614-864-4618",
            "fax_number": "614-860-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICK",
        "first_name": "WALTER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "18530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metamorphosis Counseling & Consulting LLC (Metamorphosis Counseling & Consulting)
• Elena Micevska, O.D.
• Michael J. Smith, DDS, Inc. (Reynoldsburg Family Dental)
• Michael S Tilson, DDS Ms Inc
• Michael's Angels Transportation Services LLC
• Mid Ohio Home Health Care, LLC
• Mid Ohio Medical Management,LLC
• Britannie Nichole Miller, PHARMD
• Dajuan Miller
• David Eugene Miller, PH.D.

• General Practice Dentistry in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• General Practice Dentistry in Ohio

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.