Provider Demographics
NPI:1427143445
Name:MIGHION, GEORGE A (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:MIGHION
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-8804
Mailing Address - Country:US
Mailing Address - Phone:574-256-1579
Mailing Address - Fax:574-256-5979
Practice Address - Street 1:3420 HICKORY RD
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-8804
Practice Address - Country:US
Practice Address - Phone:574-256-1579
Practice Address - Fax:574-256-5979
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200196930AMedicaid
IN711877OtherUNITED CONCORDIA