DR. JOHN DELANO MIXON SR. (NPI# 1407937808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407937808 |
| Entity Type | Individual |
| Full Name | DR. JOHN DELANO MIXON SR. |
| Credential | DDS |
| Practice Address |
1205 Sherwood Park Drive Gainesville GA 30501 |
| Practice Telephone | 7705360201 |
| Practice Fax Number | 7705310000 |
| Mailing Telephone | 7705360201 |
| Mailing Fax Number | 7705310000 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
6349 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861977134 | John Davone Mixon Sr. | Behavior Technician | 1050 Fulton Ave Ste 230, Sacramento, CA 95825-4299 | 2018-10-02 |
| 1750365276 | John W Mixon Jr. | Optometrist | 1119 E Lamar St, Americus, GA 31709-3762 | 2005-11-30 |
| Street Address |
1205 SHERWOOD PARK DRIVE |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295239713 | Erick Evandro Di Matteo | Dentist | 1395 Center Dr # D1-d9, Gainesville, FL 32610-3006 | 2018-03-20 |
| 1033629894 | Swati Gupta | Dentist | Grad Perio Clinic 1395 Center Drive D1-19, Gainesville, FL 32610-0001 | 2017-10-06 |
| 1164873485 | Juliana Sardenberg | Dentist | 1395 Center Dr # D1-19, Gainesville, FL 32610-6550 | 2016-06-28 |
| 1659732824 | Frederico Duarte Da Silva | Dentist | 2300 Sw 43rd St Apt A6, Gainesville, FL 32607-3826 | 2016-03-15 |
| 1053709733 | Justin C. Craighead Dmd, Ms, Pl | Dentist | 3720 Nw 43rd St Ste 102, Gainesville, FL 32606-6190 | 2015-01-02 |
| 1215241039 | Daniel Ryan Noorthoek | Dentist | 453 Pumpkin Dr., Gainesville, FL 33410 | 2010-08-04 |
| 1164571162 | Joseph E. Barclay | Dentist | 1206b Sherwood Park Dr Ne, Gainesville, GA 30501-3445 | 2007-01-09 |
| 1497860902 | Caleb Jewett King IIi | Dentist | 5014 Nw 27th Ct, Gainesville, FL 32606-6545 | 2006-08-21 |
| 1710092036 | Richard Watson Oliver Jr. | Dentist | 5014 Nw 27th Court, Gainesville, FL 32606-6545 | 2006-08-19 |
| 1013925502 | Gary Ian Altschuler | Dentist | 2251 Nw 41st St, Suite F, Gainesville, FL 32606-7498 | 2006-08-03 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.