Provider Demographics
NPI:1316591621
Name:AKEY, MITCHELL J (DMD)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:J
Last Name:AKEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TINGAY DENTAL CLINIC
Mailing Address - Street 2:320 E HOSPITAL RD.
Mailing Address - City:FT. EISENHOWER
Mailing Address - State:GA
Mailing Address - Zip Code:30905
Mailing Address - Country:US
Mailing Address - Phone:706-787-5102
Mailing Address - Fax:
Practice Address - Street 1:TINGAY DENTAL CLINIC
Practice Address - Street 2:320 E HOSPITAL RD.
Practice Address - City:FT. EISENHOWER
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-5102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist