Jerry Wayne Mitchell, D.D.S.

General Practice Dentistry · Ketchum, ID

Individual Active NPI

NPI number 1932289204

Practice location

620 First Ave N
Ketchum, ID 83340-0000
Phone
(208) 720-7368

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NPI record

NPI
1932289204
Entity type
Individual (Type 1)
Enumeration date
October 17, 2006
Last updated
December 13, 2012
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DE00005295 WA

Mailing address

PO Box 4378
620 First Ave N
Ketchum, ID 83340-0000
Phone
(208) 720-7368

About Dr. Mitchell

Jerry Wayne Mitchell, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 620 First Ave N, Ketchum, ID 83340-0000. The NPI number 1932289204 was assigned on October 17, 2006 and the record was last updated on December 13, 2012.

Dr. Mitchell lists a license in the registry: #DE00005295 (WA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jerry Wayne Mitchell, D.D.S.?

The NPI number is 1932289204.

What is the phone number of Dr. Mitchell?

The phone number listed for the practice location is (208) 720-7368.

Where is Dr. Mitchell located?

620 First Ave N, Ketchum, ID 83340-0000.

What is the taxonomy code for Dr. Mitchell?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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