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Organization
JAMES MITSOS DMD PLLC
Active
Organization
JAMES MITSOS DMD PLLC
Active
Other names
Southwest Pediatric Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA WIETH (DIRECTOR OF PAYOR RELATIONS)
(623) 267-8121
Entity
Organization
Contact information
Practice address
10759 WINTERSET DR, ORLAND PARK, IL 60467-1106
(708) 580-0404
(708) 966-0154
Mailing address
10759 WINTERSET DR, ORLAND PARK, IL 60467-1106
(708) 580-0404
(708) 966-0154
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/20/2021
Last updated
09/18/2026
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