Provider Demographics
NPI:1124105929
Name:WECHSLER, MITCHELL AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:AARON
Last Name:WECHSLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 WELLESLEY DR
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302
Mailing Address - Country:US
Mailing Address - Phone:818-917-8254
Mailing Address - Fax:818-880-8221
Practice Address - Street 1:2059 W AVENUE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536
Practice Address - Country:US
Practice Address - Phone:661-945-0929
Practice Address - Fax:661-723-2189
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54727122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist