Individual provider Active NPI

Nicole E Mitchell-Toth, DMD

  • Dentist
  • Tampa, FL
National Provider Identifier
1790990067
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15954 Issued in FL
Practice address
19651 Bruce B Downs Blvd Ste A1
Tampa, FL 33647-2438
Phone
(813) 957-5887
Fax
(813) 971-8064
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15954 FL Primary

Addresses

Primary practice location

19651 Bruce B Downs Blvd Ste A1
Tampa, FL 33647-2438

Mailing address

19651 Bruce B Downs Blvd Ste A1
Tampa, FL 33647-2438
Phone (813) 957-5887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20210315001224 FL Order and Referring Only - DentistPractitioner - Dentist 1658787767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15954FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1790990067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19651 BRUCE B DOWNS BLVD STE A1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472438",
            "telephone_number": "813-957-5887",
            "fax_number": "813-971-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19651 BRUCE B DOWNS BLVD STE A1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472438",
            "telephone_number": "813-957-5887",
            "fax_number": "813-971-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL-TOTH",
        "first_name": "NICOLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "15954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.