Individual provider Active NPI

Thomas W. Mullen, D.D.S.

  • General Practice Dentistry
  • Redding, CA
National Provider Identifier
1043396534
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47642 Issued in CA
Practice address
2315 Bechelli LN
Ste. F
Redding, CA 96002-0119
Phone
(530) 223-0436
Fax
(530) 223-2649
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47642 CA Primary

Addresses

Primary practice location

2315 Bechelli LN
Ste. F
Redding, CA 96002-0119

Mailing address

2315 Bechelli LN
Ste F
Redding, CA 96002-0119
Phone (530) 223-0436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160426000278 CA Order and Referring Only - DentistPractitioner - Dentist 0547309429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas W Mullen DDS Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1043396534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 BECHELLI LN",
            "address_2": "STE F",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020119",
            "telephone_number": "530-223-0436",
            "fax_number": "530-223-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 BECHELLI LN",
            "address_2": "STE. F",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020119",
            "telephone_number": "530-223-0436",
            "fax_number": "530-223-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "THOMAS",
        "middle_name": "W.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.