Individual provider Active NPI

Mitchell Duane Esquibel, D.D.S

  • Oral and Maxillofacial Pathology Dentistry
  • Rolla, MO
National Provider Identifier
1326019837
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
DE014017 Issued in MO
Practice address
1016 S Bishop Ave
Rolla, MO 65401-4416
Phone
(573) 341-3383
Fax
(573) 341-3485
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X DE014017 MO Primary

Addresses

Primary practice location

1016 S Bishop Ave
Rolla, MO 65401-4416

Mailing address

1016 S Bishop Ave
Rolla, MO 65401-4416
Phone (573) 341-3383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925002406 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739309790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE014017MOMDOral and Maxillofacial Pathology Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326019837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 S BISHOP AVE",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014416",
            "telephone_number": "573-341-3383",
            "fax_number": "573-341-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 S BISHOP AVE",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014416",
            "telephone_number": "573-341-3383",
            "fax_number": "573-341-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIBEL",
        "first_name": "MITCHELL",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MO",
            "license": "DE014017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.