Jacklyn K Mitchell, DMD, MPH

Primary specialty

DentistTaxonomy code 122300000X

License

DN22698 Issued in FL

Practice address

1395 Center Dr # D1-17
Gainesville, FL 32610-5720

Phone

(352) 273-5430

NPI assigned

Jun 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1891224986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR # D1-17",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103006",
            "telephone_number": "352-789-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR # D1-17",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326105720",
            "telephone_number": "352-273-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JACKLYN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Leigh Mitchell, MD
• Conor Adam Mitchell
• Desire Mitchell
• Freda Mitchell
• Heather Mitchell
• Jennifer M Mitchell
• Jonnetta L Mitchell
• Joy Mitchell
• Latearra Javonta Mitchell
• Madison Miller Mitchell, APRN

• Dentist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.