Individual provider Active NPI

Jonathan Paul Mueller, DDS

  • Dentist
  • Lawrence, KS
National Provider Identifier
1124914130
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62354 Issued in KS
Practice address
1312 W 6TH St
Lawrence, KS 66044-2219
Phone
(785) 841-7297
Fax
(785) 856-0375
NPI assigned
Jun 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62354 KS Primary

Addresses

Primary practice location

1312 W 6TH St
Lawrence, KS 66044-2219

Mailing address

1312 W 6TH St
Lawrence, KS 66044-2219
Phone (785) 841-7297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20250711002437 KS Practitioner - Dentist 8224543079 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62354KSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Medical Clinic, Inc CurrentSince Jul 9, 2025 Accepting new patients
Heartland Medical Clinic, Inc CurrentSince Jul 9, 2025 Accepting new patients
Heartland Medical Clinic, Inc. Past Accepting new patients

Locations

1312 W 6th St
Lawrence, KS 66044
Phone (785) 841-7297

1803 W 6th St
Lawrence, KS 66044
Phone (785) 841-7297

Organizations & group practices 3

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1124914130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 W 6TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442219",
            "telephone_number": "785-841-7297",
            "fax_number": "785-856-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 W 6TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442219",
            "telephone_number": "785-841-7297",
            "fax_number": "785-856-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "62354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.