MEDICARE: DR. JOHN KEITH MITCHELL DDS

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	122300000X	Dentist	TX15354	TX

General Provider Information

NPI Number	:	1851483937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN KEITH MITCHELL DDS

Provider Business Mailing Address
First Line	:	3114 N OCONNOR
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062
Country	:	US
Telephone Number	:	972-252-3020
Fax Number	:	972-252-3050

Provider Business Practice Location Address
First Line	:	3114 N OCONNOR RD.
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062
Country	:	US
Telephone Number	:	972-252-3020
Fax Number	:	972-252-3050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	05/20/2026

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