Individual provider Active NPI

David H Mishler Jr., D.D.S.

  • Periodontics
  • Lindon, UT
National Provider Identifier
1861692360
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
4947499-9923 Issued in UT
Practice address
165 N 400 W
Lindon, UT 84042-1817
Phone
(415) 264-3409
NPI assigned
Jul 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 4947499-9923 UT Primary
Dentist 122300000X 1243 AK

Addresses

Primary practice location

165 N 400 W
Lindon, UT 84042-1817

Mailing address

165 N 400 W
Lindon, UT 84042-1817
Phone (415) 264-3409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20191111000956 UT Order and Referring Only - DentistPractitioner - Dentist 2062718182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1243AKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Premier Dental Group- Ste100,LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1861692360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N 400 W",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421817",
            "telephone_number": "415-264-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N 400 W",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421817",
            "telephone_number": "415-264-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHLER",
        "first_name": "DAVID",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "4947499-9923",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindon, UT

Sources for this page

Verify at the official NPI Registry.