Virgil M Mylan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8250 Issued in MN

Practice address

4954 Lincoln Dr
Edina, MN 55436-1071

Phone

(952) 935-3532

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Practice roles

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.

• Edina Family Dental Assoc., P.a.

  • General Practice Dentistry
  • Edina, MN
  • NPI 1033279393
  NPD (past) Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093875882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4954 LINCOLN DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361071",
            "telephone_number": "952-935-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4954 LINCOLN DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361071",
            "telephone_number": "952-935-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLAN",
        "first_name": "VIRGIL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayan Mohamed Musse, DNP
• Raani Musse
• Jack Leon-Max Mutnick, M.D.
• Cheryl Lynn Mutschler, LAC
• Alexandra Mary Tamsin Myhill-Jones
• Jennifer Lynn Naas, D.C.
• Yamit Frances Nachmias, DC
• Michael Ryan Nachreiner, LPCC, LADC
• John Charles Nadeau, M.D.
• Kay Lynn Naggatz, M.S.,CCC-A

• General Practice Dentistry in Edina, MN
• Providers in Edina, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.