Active NPI
Wesley Clark Mullen, DDS
- Dentist
- Ozark, MO
National Provider Identifier
1023372968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2013013394
- Practice address
- 5520 N Farmer Branch Rd
Ozark, MO 65721-5315 - Phone
- (417) 582-7030
- NPI assigned
- Jun 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2013013394 | MO | Primary |
Addresses
Primary practice location
5520 N Farmer Branch Rd
Ozark, MO 65721-5315
Mailing address
PO Box 1359
Ava, MO 65608-1359
Phone (417) 683-4831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013013394 | MO | MD | Dentist |
Networks
- IA HMO C-SNP
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1023372968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1359",
"city": "AVA",
"state": "MO",
"postal_code": "656081359",
"telephone_number": "417-683-4831",
"fax_number": "417-683-1602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5520 N FARMER BRANCH RD",
"city": "OZARK",
"state": "MO",
"postal_code": "657215315",
"telephone_number": "417-582-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "WESLEY",
"middle_name": "CLARK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2013013394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ozark, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.