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PATHAMAS CHANTARACHERD MITTMAN DDS, MS
NPI 1447972922
Dentist - Orofacial Pain in Plymouth, MN

Active since September 13, 2022PECOS EnrolledAccepts Medicare Assignment
3475 PLYMOUTH BLVD STE 200, PLYMOUTH, MN 55447(763) 577-2484(763) 577-1375 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pathamas Chantaracherd Mittman Dds, Ms NPPES

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

PATHAMAS CHANTARACHERD MITTMAN DDS, MS (NPI 1447972922) is an individual orofacial pain provider in Plymouth, Minnesota, licensed in Minnesota (S187) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1447972922
Entity TypeIndividualFemale
Primary Taxonomy1223X2210X
Provider Legal NamePATHAMAS CHANTARACHERD MITTMANCredential: DDS, MS
Location Address3475 PLYMOUTH BLVD STE 200Plymouth, MN 55447-1539
Mailing Address3475 Plymouth Blvd Ste 200Plymouth, MN 55447-1539 · (763) 577-2484 · Fax (763) 577-1375
Phone(763) 577-2484
Fax(763) 577-1375
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 13, 2022
NPPES CertifiedSeptember 13, 2022
✔ NPI 1447972922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Orofacial PainDental Providers
Taxonomy Code1223X2210X
License✔ Licensed in MN · S187
Definition
A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.
3475 PLYMOUTH BLVD STE 200, Plymouth, MN 55447
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1675 E Nicollet Blvd Ste 255Burnsville, MN 55337-6768 · Phone (952) 892-6222 · Fax (952) 892-6477
Location 22550 University Ave W Ste 189SSaint Paul, MN 55114-2001 · Phone (651) 332-7474 · Fax (651) 332-7475
Location 3622 Roosevelt Rd Ste 120Saint Cloud, MN 56301-6349 · Phone (952) 892-6222 · Fax (952) 892-6477

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pathamas Chantaracherd Mittman Dds, Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567832116
PECOS Enrollment IDI20221223000855
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
23 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55447 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

LORI L SANDBERG PT
Physical Medicine & Rehabilitation (Pain Medicine)
3475 PLYMOUTH BLVD STE 200
PLYMOUTH, MN 55447
Hennepin County (763) 577-2484
MINNESOTA PAIN PREVENTION CLINIC, P.A.
Pain Medicine (Pain Medicine)
3475 PLYMOUTH BLVD STE 200
MINNEAPOLIS, MN 55447
Hennepin County (612) 619-1678
JAMES R FRICTON DDS
Dentist (Orofacial Pain)
3475 PLYMOUTH BLVD STE 200
PLYMOUTH, MN 55447
Hennepin County (763) 577-2484

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 Pathamas Mittman's NPI number?

The NPI number for Pathamas Mittman is 1447972922. It was assigned to this individual provider in the NPPES registry on September 13, 2022.

Where is Pathamas Mittman located?

Pathamas Mittman practices at 3475 Plymouth Blvd Ste 200, Plymouth, MN 55447. The listed phone number is (763) 577-2484.

What is Pathamas Mittman's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orofacial Pain, with taxonomy code 1223X2210X.

Is Pathamas Mittman enrolled in Medicare?

Yes. Pathamas Mittman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Pathamas Mittman accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and UnitedHealthcare list Pathamas Mittman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pathamas Mittman was last updated on September 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.