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
- 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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Charleston, WV
- NPI 1366181984
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.