Provider Demographics
NPI:1205053576
Name:MITCHELL, ROBERT DAVID (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
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 1:6395 S MCCARRAN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6101
Mailing Address - Country:US
Mailing Address - Phone:775-823-9419
Mailing Address - Fax:
Practice Address - Street 1:6395 S MCCARRAN BLVD STE B
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6101
Practice Address - Country:US
Practice Address - Phone:775-823-9419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA279041223X0400X
NVS3-319C1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics