Richard Louis Mitchell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11371 Issued in MN

Practice address

607 1St Dr NW
Austin, MN 55912-3072

Phone

(507) 437-6312

NPI assigned

Oct 17, 2006

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Potach & Mitchell Dental Clinic PA

  • Dental Clinic/Center
  • Austin, MN
  • NPI 1902962582
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1477634590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559123072",
            "telephone_number": "507-437-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559123072",
            "telephone_number": "507-437-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "RICHARD",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Jo Miller, RPH
• Stanley R Miller, PSY.D.,L.P.
• Angela Marie Miner, APRN, CNM
• Carol Anne Minzel, CNP
• Izza Mir, D.O.
• Victor Nasser Mizrachi, M.D.
• Christine Elizabeth Moon, APRN
• Moran Professional Corporation
• Moran Professional Services
• Todd Francis Moran, PHD, LICSW

• General Practice Dentistry in Austin, MN
• Providers in Austin, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.