Organization Active NPI

Chris Mueller DDS PLLC

  • Dentist
  • Port Orchard, WA
National Provider Identifier
1255671640
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9087 Issued in WA
Legal business name
CHRIS MUELLER DDS PLLC
Practice address
1420 Bay St
Port Orchard, WA 98366-5102
Phone
(360) 895-1401
Fax
(360) 895-1296
NPI assigned
Feb 21, 2013
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Tammie Farley
Title
Office Manager
Phone
(360) 895-1401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9087 WA Primary

Addresses

Primary practice location

1420 Bay St
Port Orchard, WA 98366-5102

Mailing address

1420 Bay St
Port Orchard, WA 98366-5102
Phone (360) 895-1401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130603000108 WA DME Supplier - Oral Surgery - Dentist 8921246950 Practice locations: Port Orchard, WA

National Provider Directory

National Provider Directory

Locations

1420 Bay St
Port Orchard, WA 98366
Phone (360) 895-1401

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1255671640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 BAY ST",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665102",
            "telephone_number": "360-895-1401",
            "fax_number": "360-895-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 BAY ST",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665102",
            "telephone_number": "360-895-1401",
            "fax_number": "360-895-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS MUELLER DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-895-1401"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "9087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.