Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mitch Ty Carpenter-Thompson

Individual provider Dentist · NPI 1134746290

Mitch Ty Carpenter-Thompson is a Dentist in Lake City, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2020
Specialties on file
2

Practice location Address checks out

213 S Canal St
Lake City, MI 49651-8865
Phone: (231) 839-2630
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 600446 (MI)
Dentist Taxonomy 122300000X · Licence 014317 (MI)

Record details

NPI number1134746290
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 6, 2020
Last updated in NPPESOctober 7, 2021
Certification dateOctober 7, 2021
Mailing addressPo Box 719, Lake City, MI 49651-0719