Mitch Driscoll, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D4644 Issued in ID

Practice address

81 W Washington Ave
Aberdeen, ID 83210-4801

Phone

(208) 397-4198

Fax

(208) 397-5606

NPI assigned

Jun 30, 2014

Sex

Male

Sole proprietor

No

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 ID

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 and National Provider Directory roles.

• Driscoll Dental, PLLC

  • General Practice Dentistry
  • Aberdeen, ID
  • NPI 1124488507
  NPD (past) Authorized official

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1790190692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 W WASHINGTON AVE",
            "address_2": "PO BOX 837",
            "city": "ABERDEEN",
            "state": "ID",
            "postal_code": "832104801",
            "telephone_number": "208-397-4198",
            "fax_number": "208-397-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W WASHINGTON AVE",
            "city": "ABERDEEN",
            "state": "ID",
            "postal_code": "832104801",
            "telephone_number": "208-397-4198",
            "fax_number": "208-397-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "MITCH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aberdeen- Springfield Fire District
• County of Bingham School Dist Aberdeen Class a
• Driscoll Dental, PLLC
• Natalie Fuss
• Health West, Inc.
• Debra S McKay, PA-C
• Power County Hospital District
• Heather Ann Schaper, PA

• All providers in Aberdeen, ID
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.