Shelly Mixson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012436 Issued in GA

Legal business name

SHELLY MIXSON

Practice address

1133 E West Connector
Austell, GA 30106-1589

Phone

(770) 333-9951

Fax

(770) 333-9953

NPI assigned

Mar 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Shelly Mixson, D.M.D

Title

Owner

Phone

(770) 333-9951

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1861664880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061589",
            "telephone_number": "770-333-9951",
            "fax_number": "770-333-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061589",
            "telephone_number": "770-333-9951",
            "fax_number": "770-333-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY MIXSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "MIXSON",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-333-9951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "101592",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9185964",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chintu S Shah, MD
• Jyoti Sharma, MD
• Sharon'S Caring Homecare
• Sarah Anne Shaver, MD
• David Lawson Shaw, MD
• Christine Andrews Shenk, PTA
• Breonna Jarraye Shepherd, PHARM.D.
• Afshin Shirinzadeh, D.C.
• Shree Yamuna Maharaniji,PC
• Aseem Shrivastava, MD

• General Practice Dentistry in Austell, GA
• Providers in Austell, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.