Active NPI
Kristen Alyssa Mullins, DDS
- Dentist
- Charleston, WV
National Provider Identifier
1124869425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4696
- Practice address
- 1516 Kanawha Blvd W
Charleston, WV 25387-2533 - Phone
- (304) 345-7272
- Fax
- (304) 345-7287
- NPI assigned
- Jun 3, 2024
- Last updated
- Jun 3, 2024
- Sex
- Female
- 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 | 4696 | WV | Primary |
Addresses
Primary practice location
1516 Kanawha Blvd W
Charleston, WV 25387-2533
Mailing address
1516 Kanawha Blvd W
Charleston, WV 25387-2533
Phone (304) 345-7272
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 |
|---|---|---|---|
| 4696 | WV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reed Dental | Current | Accepting new patients |
Locations
1516 Kanawha Blvd W
Charleston, WV 25387
Phone (304) 345-7272
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1124869425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 KANAWHA BLVD W",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253872533",
"telephone_number": "304-345-7272",
"fax_number": "304-345-7287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 KANAWHA BLVD W",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253872533",
"telephone_number": "304-345-7272",
"fax_number": "304-345-7287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "KRISTEN",
"middle_name": "ALYSSA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-03",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "4696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.