NPIMap

Organization Active NPI

Coastal Jaw Surgery of New Port Richey PA

  • Oral and Maxillofacial Surgery (Dentist)
  • New Port Richey, FL
National Provider Identifier
1487839205
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
COASTAL JAW SURGERY OF NEW PORT RICHEY PA
Practice address
6731 Madison St
New Port Richey, FL 34652-1928
Phone
(727) 842-5180
Fax
(727) 846-0755
NPI assigned
Dec 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Authorized official

Name
Dr. Mark W Mitchell, DDS
Title
President
Phone
(727) 842-5180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

6731 Madison St
New Port Richey, FL 34652-1928

Mailing address

6731 Madison St
New Port Richey, FL 34652-1928
Phone (727) 842-5180

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1487839205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6731 MADISON ST",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346521928",
            "telephone_number": "727-842-5180",
            "fax_number": "727-846-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6731 MADISON ST",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346521928",
            "telephone_number": "727-842-5180",
            "fax_number": "727-846-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL JAW SURGERY OF NEW PORT RICHEY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-842-5180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; 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.