Bryan Mark Mitchell, D.D.S., M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

30805 Issued in TX

Practice address

1213 Hermann Dr Ste 845
Houston, TX 77004-7027

Phone

(346) 396-5673

Fax

(346) 396-5674

NPI assigned

May 29, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1740692490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 HERMANN DR STE 845",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770047027",
            "telephone_number": "346-396-5673",
            "fax_number": "346-396-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 HERMANN DR STE 845",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770047027",
            "telephone_number": "346-396-5673",
            "fax_number": "346-396-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRYAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2022-03-30",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "9355",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "30805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arieal Mitchell, APRN
• Arthur Steve Mitchell, LCDC
• Ashley Mochelle Mitchell, M.S.-CFY
• Ashley Shaquelle Mitchell, LMSW
• Becky O Mitchell, LPC
• Candice Mitchell, PHARMD
• Cardona Toyin Mitchell, ED.D
• Carrie A Mitchell
• Charlie Mitchell, PHYSICIAN ASSISTANT
• Cheryl R Mitchell, OT

• Endodontics in Houston, TX
• Providers in Houston, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.