Individual provider Active NPI

David T Mullen, DDS

  • Dentist
  • New Milford, CT
National Provider Identifier
1043242134
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9288 Issued in CT
Practice address
16 Sunny Valley Rd
New Milford, CT 06776-3323
Phone
(860) 354-1400
Fax
(860) 354-5343
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9288 CT Primary

Addresses

Primary practice location

16 Sunny Valley Rd
New Milford, CT 06776-3323

Mailing address

16 Sunny Valley Rd
New Milford, CT 06776-3323
Phone (860) 354-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20150629001819 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517279896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9288CTMDDentist
009288CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043242134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SUNNY VALLEY RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763323",
            "telephone_number": "860-354-1400",
            "fax_number": "860-354-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SUNNY VALLEY RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763323",
            "telephone_number": "860-354-1400",
            "fax_number": "860-354-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "DAVID",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "9288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.