Matthew C Mitchell, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

806 Issued in KY

Practice address

211 High Point CT
Suite 500
Mt Washington, KY 40047-5528

Phone

(502) 538-2400

Fax

(502) 538-2403

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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.

• Arrow Dental PLLC

  • Dental Clinic/Center
  • Mt Washington, KY
  • NPI 1497376248
  NPD (past)
• Kentuckiana Pediatric Dentistry

  • Pediatric Dentistry
  • Mt Washington, KY
  • NPI 1851785877
  NPD (past)
• Kentuckiana Peds Dre LLC

  • Pediatric Dentistry
  • Mt Washington, KY
  • NPI 1093580219
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1871698043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HIGH POINT CT",
            "address_2": "SUITE 500",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400475528",
            "telephone_number": "502-538-2400",
            "fax_number": "502-538-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HIGH POINT CT",
            "address_2": "SUITE 500",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400475528",
            "telephone_number": "502-538-2400",
            "fax_number": "502-538-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100071020",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica McDermott, PHARMD
• Ryan McGiffen, O.D.
• Haley McVey, LCSW
• Liane McWilliams, MASSAGE THERAPIST
• Dianne Metzmeier
• Mooney Eyecare Centre, PLLC
• Matthew Lutes Mooney, O.D.
• Mount Washington Health Care LLC
• Mt Washington Family Dentistry Nita S Isgrigg DMD, PSC
• Mt Washington Family Practice PLLC

• Pediatric Dentistry in Mt Washington, KY
• Providers in Mt Washington, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.