Provider Demographics
NPI:1225191356
Name:MAYHEW, MICHAEL JOSEPH (DDS MS HS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:MAYHEW
Suffix:
Gender:M
Credentials:DDS MS HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 BOONE HEIGHTS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-264-0110
Mailing Address - Fax:828-264-5453
Practice Address - Street 1:373 BOONE HEIGHTS DRIVE
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-264-0110
Practice Address - Fax:828-264-5453
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC46641223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0148790068OtherADA
NC7995589Medicaid
AM8793451OtherDEA
U36903Medicare UPIN