Dr. Larry Wallace Mizelle , DDS
Dentist - General Practice • Temperance, MI
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Larry Mizelle has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Larry Mizelle, DDS was a registered Dentist - General Practice practicing in Temperance, MI. Throughout an active medical career spanning 12 years, Dr. Mizelle provided care at the practice location at 7298 JACKMAN RD until profile deactivation on 2019-11-04.
Practice Location & Contact Primary Location
7298 Jackman Rd
Temperance, MI 481821313
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Temperance, MI
Practicing in Temperance, MI (4360 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on November 04, 2019
NPI status registered as active in NPPES database
Registered at 7298 JACKMAN RD, TEMPERANCE, MI 481821313 (Tel: 7348476350)
Registered at 7298 JACKMAN RD, TEMPERANCE, MI 481821313 (Tel: 7348476350)
Recorded as LARRY MIZELLE, DDS
Dentist (License #10910 in MI)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
7298 Jackman Rd
Temperance, MI 481821313
Phone: 7348476350
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