Active NPI
Jason Graham Mullins Jr., D.M.D.
- Dentist
- Montgomery, AL
National Provider Identifier
1215310040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6218
- Practice address
- 1845 Cherry St
Montgomery, AL 36107-2613 - Phone
- (334) 669-1080
- NPI assigned
- Jun 29, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 6218 | AL | Primary |
Addresses
Primary practice location
1845 Cherry St
Montgomery, AL 36107-2613
Mailing address
1845 Cherry St
Montgomery, AL 36107-2613
Phone (334) 420-5001
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 |
|---|---|---|---|
| 6218 | AL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1215310040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1845 CHERRY ST",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361072613",
"telephone_number": "334-420-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 CHERRY ST",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361072613",
"telephone_number": "334-669-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "JASON",
"middle_name": "GRAHAM",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-29",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "6218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.