MEDICARE: MIKE MYSINGER, DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1386570240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIKE MYSINGER, DDS

Provider Business Mailing Address
First Line	:	120 CAPITAL DR STE 101
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3475
Country	:	US
Telephone Number	:	865-693-7070
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 CAPITAL DR STE 101
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3475
Country	:	US
Telephone Number	:	865-693-7070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MIKE DOUGLAS MYSINGER
Credential	:	DDS
Telephone Number	:	865-693-7070

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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