Provider Demographics
NPI:1417488560
Name:MITCHELL, AARIKA BOGGS (DMD)
Entity Type:Individual
Prefix:
First Name:AARIKA
Middle Name:BOGGS
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AARIKA
Other - Middle Name:CALISSE
Other - Last Name:BOGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3835
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-3835
Mailing Address - Country:US
Mailing Address - Phone:206-548-3114
Mailing Address - Fax:206-762-6355
Practice Address - Street 1:6020 35TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3002
Practice Address - Country:US
Practice Address - Phone:206-461-6966
Practice Address - Fax:206-461-6968
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60862698122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist