John L. Mixer, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901011411 Issued in MI

Practice address

1150 E Sherman Blvd
Suite 1600
Muskegon, MI 49444-1871

Phone

(231) 733-1571

Fax

(231) 733-5228

NPI assigned

Mar 14, 2006

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• West Shore Oral & Maxillofacial Surgery Associates, PLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Norton Shores, MI
  • NPI 1053458604
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1689643777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD",
            "address_2": "SUITE 1600",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441871",
            "telephone_number": "231-733-1571",
            "fax_number": "231-733-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD",
            "address_2": "SUITE 1600",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441871",
            "telephone_number": "231-733-1571",
            "fax_number": "231-733-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXER",
        "first_name": "JOHN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901011411",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901011411",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4193792",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4204519",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MEDICAL",
            "identifier": "97 0 F1 1036 0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL",
            "identifier": "D800376",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Missi Nadeau PH.D. P.L.C.
• Kelsey Marie Mitchell, MSW
• Michelle Renea Mitchell
• Reid Mitchell, DO
• Shakia Mitchell
• Mmsi LLC
• Jessica Lynn Moccardine
• Randi Michelle Mock
• Julie Mohan, CNM
• Anna Mohr, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.