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General NPI Number Information
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NPI Number | 1447197645
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Entity Type | Individual
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Provider Name | JENNIFER MITCHELL RDH
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Gender | Female
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 27690 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-2842
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Country | US
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Telephone | 586-465-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 48862 POINT LAKEVIEW DR
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City | CHESTERFIELD
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State | MI
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Zip | 48047-3417
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Country | US
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Telephone | 586-801-4482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902012736
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License Number State | MI
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