John R Mullan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS022401L Issued in PA

Practice address

1015 S 13TH St
Altoona, PA 16602-6013

Phone

(814) 944-4907

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1205916228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S 13TH ST",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026013",
            "telephone_number": "814-944-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S 13TH ST",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026013",
            "telephone_number": "814-944-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLAN",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "6993",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS022401L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFFESIONAL LICENSE",
            "identifier": "DS022401L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Moyer
• Donald E Mrdjenovich, DPM
• Kimberly A Muffie, PA-C
• John Muir, PHARM.D.
• Andy Mulhollen
• Kimberly Mullen
• Kanwarpal Multani, DO
• Kelsey Murgas, PHARMD
• Debra L Muri, CRNA
• Joan Muriceak, PHARMD

• General Practice Dentistry in Altoona, PA
• Providers in Altoona, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.