Provider Demographics
NPI:1689772550
Name:MITCHELL, JOSEPH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 COOPER RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9394
Mailing Address - Country:US
Mailing Address - Phone:614-888-6811
Mailing Address - Fax:614-568-0628
Practice Address - Street 1:660 COOPER RD
Practice Address - Street 2:STE 200
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-9394
Practice Address - Country:US
Practice Address - Phone:614-888-6811
Practice Address - Fax:614-568-0628
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH141251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice