Randall W Mikulik, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19915 Issued in TX

Practice address

1533 S Brownlee Blvd Ste 100
Corpus Christi, TX 78404-3131

Phone

(808) 218-6650

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1073698544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 S BROWNLEE BLVD STE 100",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 S BROWNLEE BLVD STE 100",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043131",
            "telephone_number": "808-218-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULIK",
        "first_name": "RANDALL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "HI",
            "license": "DT-2054",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-2054",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "241943",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII DENTAL SERVICE",
            "identifier": "2054",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00992101",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collen Migrino, NP
• Miguel a. Berastain, M.D., P.a.
• Colin Antony Mihalik, DDS
• Jennifer Leigh Mike-Mayer, M.D.
• Camille Mikulencak
• Emil L. Milano, M.D.
• Michael M. Milanovich, D.M.D.
• Mildred P. Zafra ,Mdpa
• Daniel A Millan, MD
• Linda Millard, BASDH

• General Practice Dentistry in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.