Quinn Mitchell, B.D.S

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

60055426 Issued in WA

Practice address

128 E Prairie St
Sequim, WA 98382-3818

Phone

(360) 504-3636

Fax

(360) 504-3536

NPI assigned

Mar 2, 2012

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 22, 2016 through Feb 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1629342092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E PRAIRIE ST",
            "address_2": "HERITAGE ENDODONTICS",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823818",
            "telephone_number": "360-504-3636",
            "fax_number": "360-504-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E PRAIRIE ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823818",
            "telephone_number": "360-504-3636",
            "fax_number": "360-504-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "QUINN",
        "credential": "B.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN 19447",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "60055426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004716800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN19447",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Mills
• Jennifer Faye Mills, LMP
• Lisa Miner, P.A.C.
• Larri Ann Mishko, D.O.
• Lyndsay Jane Mishko, DC
• Merry R Moore, LMP.
• Roderick Scott Moore, RPH
• Valerie Ann Morgan, LICENSE MASSAGE THER
• Britton Derek Moss, PT
• Mountain View Hearing Aid Center LLC

• Endodontics in Sequim, WA
• Providers in Sequim, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.