Active NPI
Shelly Mixson
- General Practice Dentistry
- Austell, GA
National Provider Identifier
1861664880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN012436
- 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
- Last updated
- Mar 31, 2008
- Organization subpart
- No
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN012436 | GA | Primary |
Addresses
Primary practice location
1133 E West Connector
Austell, GA 30106-1589
Mailing address
1133 E West Connector
Austell, GA 30106-1589
Phone (770) 333-9951
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Atlanta, GA
- NPI 1952467425
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Austell, GA
Sources for this page
- 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.