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DR. MITCHELL LOO DMD
NPI 1487901336
Oral & Maxillofacial Surgery in Henderson, NV

Active since August 10, 2012PECOS Enrolled
2835 SAINT ROSE PKWY STE 100, HENDERSON, NV 89052(702) 900-4780 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 1, 2024, Sep 12, 2024, Jan 18, 2023 and 2 more (5 updates tracked since 2017).

About Dr. Mitchell Loo Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MITCHELL LOO DMD (NPI 1487901336) is an individual oral & maxillofacial surgery provider in Henderson, Nevada, licensed in Nevada (S2-199C) and active in the NPI registry since August 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487901336
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. MITCHELL LOOCredential: DMD
Location Address2835 SAINT ROSE PKWY STE 100Henderson, NV 89052-4847
Mailing Address276 Bouret PlHenderson, NV 89012-3129 · (857) 588-2085
Phone(702) 900-4780
Sole ProprietorNo
Enumeration DateAugust 10, 2012
Last NPPES UpdateOctober 1, 20245 updates tracked since enumeration
NPPES CertifiedOctober 1, 2024
✔ NPI 1487901336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in NV · S2-199C
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License S2-199C (NV)
2835 SAINT ROSE PKWY STE 100, Henderson, NV 89052
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Anthem Blue Cross and Blue Sheld and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mitchell Loo Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mitchell Loo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pacific Maxillofacial Center, LLC
2,760 mi
Oral and Maxillofacial Surgery
1060 YOUNG ST, SUITE 312
Honolulu, HI 96814
  • Reassigned Medicare billing, Hawaii enrollment
  • 4 clinicians in this Medicare group
NPI 1003839069 (808) 585-8455

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WON JONG LEE DDS MD
Dentist (Oral and Maxillofacial Surgery)
2835 SAINT ROSE PKWY STE 100
HENDERSON, NV 89052
Clark County (310) 715-9585
S. HUANG, DDS, PLLC
Dentist (Oral and Maxillofacial Surgery)
2835 SAINT ROSE PKWY STE 100
HENDERSON, NV 89052
Clark County (702) 270-2999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitchell Loo's NPI number?

The NPI number for Mitchell Loo is 1487901336. It was assigned to this individual provider in the NPPES registry on August 10, 2012.

Where is Mitchell Loo located?

Mitchell Loo practices at 2835 Saint Rose Pkwy Ste 100, Henderson, NV 89052. The listed phone number is (702) 900-4780.

What is Mitchell Loo's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Mitchell Loo enrolled in Medicare?

Yes. Mitchell Loo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mitchell Loo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mitchell Loo reassigns Medicare benefits to Pacific Maxillofacial Center, LLC (Honolulu, HI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mitchell Loo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mitchell Loo accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield and BEST Life and 16 other insurers list Mitchell Loo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mitchell Loo was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.