MEDICARE: PLANO ORTHODONTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1235073123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANO ORTHODONTICS

Provider Business Mailing Address
First Line	:	6333 SMITHFIELD RD
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-4610
Country	:	US
Telephone Number	:	775-450-0392
Fax Number	:

Provider Business Practice Location Address
First Line	:	8240 PRESTON RD STE 170
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2376
Country	:	US
Telephone Number	:	775-450-0392
Fax Number	:

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	DR. JESSE ALAN MITCHEM
Credential	:	DDS MSD
Telephone Number	:	775-450-0392

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “PLANO ORTHODONTICS ” Practice Location

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