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JUAN MITCHELL JR. DMD
NPI 1275330854
Student in an Organized Health Care Education/Training Program in Hartford, CT

Active since February 28, 2025PECOS Enrolled
1000 ASYLUM AVE STE 3200, HARTFORD, CT 06105(860) 714-5782 Get Directions Write a Review

NPPES record last updated: March 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Juan Mitchell Jr. Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUAN MITCHELL JR. DMD (NPI 1275330854) is an individual student in an organized health care education/training program in Hartford, Connecticut and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS and is a graduate of University Of Connecticut School Of Dental Medicine (2025).

NPPES Registry Identity

NPI1275330854
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJUAN MITCHELL JR.Credential: DMD
Location Address1000 ASYLUM AVE STE 3200Hartford, CT 06105-1702
Mailing Address2100 Stanley StNew Britain, CT 06053-1555
Phone(860) 714-5782
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of Dental MedicineGraduated 2025
Enumeration DateFebruary 28, 2025
Last NPPES UpdateMarch 1, 2025
NPPES CertifiedMarch 1, 2025
✔ NPI 1275330854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
1000 ASYLUM AVE STE 3200, Hartford, CT 06105
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Juan Mitchell Jr. Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6507322781
PECOS Enrollment IDI20260728003964
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Juan Mitchell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Athens Model Neighborhood Health Center Inc
793 mi
Federally Qualified Health Center (FQHC)
402 MCKINLEY DRIVE
Athens, GA 30601
  • Reassigned Medicare billing, Georgia enrollment
  • 14 clinicians in this Medicare group
NPI 1275751448 (706) 543-1145

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARTIME VINCA
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-4995
AMANDA R NUNEZ DMD
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-5782
DR. NIZIDA VALIUSKA ACHARTE DMD
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-5782
SARAH A HERBSMAN
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-4995
DR. YOONA LEE DDS
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-4529
ABUBAKR SHAFI DDS
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-5782
DR. SAMANTHA KOZAKOWSKI DMD
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-5782
SUNIL K REDDY DMD
Student in an Organized Health Care Education/Training Program
1000 ASYLUM AVE STE 3200
HARTFORD, CT 06105
Capitol Planning Region (860) 714-5782

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Juan Mitchell's NPI number?

The NPI number for Juan Mitchell is 1275330854. It was assigned to this individual provider in the NPPES registry on February 28, 2025.

Where is Juan Mitchell located?

Juan Mitchell practices at 1000 Asylum Ave Ste 3200, Hartford, CT 06105. The listed phone number is (860) 714-5782.

What is Juan Mitchell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Juan Mitchell enrolled in Medicare?

Yes. Juan Mitchell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Juan Mitchell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Juan Mitchell reassigns Medicare benefits to Athens Model Neighborhood Health Center Inc (Athens, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Juan Mitchell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Juan Mitchell was last updated on March 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.