Active NPI
Michael A. Mikitka, D.D.S.
- Prosthodontics
- Sacramento, CA
National Provider Identifier
1982704151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 22253
- Practice address
- 1675 Alhambra Blvd
Suite F
Sacramento, CA 95816-7047 - Phone
- (916) 455-3247
- Fax
- (916) 455-0439
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 22253 | CA | Primary |
Addresses
Primary practice location
1675 Alhambra Blvd
Suite F
Sacramento, CA 95816-7047
Mailing address
11892 Prospect Hill Dr
Gold River, CA 95670-8259
Phone (916) 852-8284
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22253 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alhambra Dental Plaza | 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.
-
- General Practice Dentistry
- Sacramento, CA
- NPI 1104927821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982704151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11892 PROSPECT HILL DR",
"city": "GOLD RIVER",
"state": "CA",
"postal_code": "956708259",
"telephone_number": "916-852-8284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 ALHAMBRA BLVD",
"address_2": "SUITE F",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958167047",
"telephone_number": "916-455-3247",
"fax_number": "916-455-0439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKITKA",
"first_name": "MICHAEL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "22253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.