Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1891233722 Individual Practitioner Female Practitioner

Dr. Mica Mathison , DMD

Dentist - General Practice • Kodak, TN

Professional Overview & Biography Verified Profile Summary

Dr. Mica Mathison, DMD is a registered healthcare professional specializing in Dentist - General Practice in Kodak, TN. Practice services are available at 2946 WINFIELD DUNN PKWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2946 Winfield Dunn Pkwy

Kodak, TN 377644306

Telephone 8654657058
Associated Practice Facility / Clinic
🏢 Eugene Stinson Dds Facility NPI 1639541543

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Kodak, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.5 Yrs
Regional Practice Density
3 Specialists

Practicing in Kodak, TN (2175 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-10-26
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TN DS0000010581

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License GA DN015719

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1144679523

Doctor of Dental Surgery

Noelan Schafer

Dentist - General Practice

NPI 1245779701
Dr. Joseph Roberto , DDS

Dentist - General Practice

NPI 1538851332

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location October 26, 2020

Registered at 2946 WINFIELD DUNN PKWY, KODAK, TN 377644306 (Tel: 8654657058)

📍
Updated Business Mailing Address October 26, 2020

Registered at 2946 WINFIELD DUNN PKWY, KODAK, TN 377644306 (Tel: 8654657058)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2020

Dentist (License #DS0000010581 in TN)

📍
Updated Practice Location July 10, 2018

Registered at 4030 WINDER HWY, FLOWERY BRANCH, GA 30542 (Tel: 6782756912)

📍
Updated Business Mailing Address July 10, 2018

Registered at 4030 WINDER HWY, FLOWERY BRANCH, GA 305423021 (Tel: 6782756912)

👤
Provider Name / Credentials Updated July 10, 2018

Recorded as MICA MATHISON, DMD

NPI Profile Active February 11, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location February 11, 2017

Registered at 875 UNION AVE, MEMPHIS, TN 381033513 (Tel: 9014482242)

📍
Updated Business Mailing Address February 11, 2017

Registered at 2047 GOLFVIEW CT APT 2C, WHEATON, IL 601898624 (Tel: 7653668594)

👤
Provider Name / Credentials Updated February 11, 2017

Recorded as MICA MATHISON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 11, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891233722
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 11, 2017
Last Update: October 26, 2020
Sole Proprietor: No

Mailing Address

2946 Winfield Dunn Pkwy

Kodak, TN 377644306

Phone: 8654657058

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.