Provider Demographics
NPI:1619987542
Name:MITCHELL, JOE I (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:I
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 E ROMIE LN
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4223
Mailing Address - Country:US
Mailing Address - Phone:831-422-7424
Mailing Address - Fax:831-758-6563
Practice Address - Street 1:780 E ROMIE LN
Practice Address - Street 2:G
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4223
Practice Address - Country:US
Practice Address - Phone:831-422-7424
Practice Address - Fax:831-758-6563
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA254261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics