Megan Lynn Mulligan, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D12786 Issued in MN

Practice address

4525 Timberline CT
Vadnais Heights, MN 55127-6024

Phone

(612) 419-0402

NPI assigned

Jun 21, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Megan Lynn Bowers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Grand Dental Care, PLLC

  • Dental Clinic/Center
  • Saint Paul, MN
  • NPI 1659964179
  NPD

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1275854580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 TIMBERLINE CT",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276024",
            "telephone_number": "612-419-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 TIMBERLINE CT",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276024",
            "telephone_number": "612-419-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "MEGAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12786",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60285539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "BOWERS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Claire Mitchell, PA
• Soo Y Moon, MA, LMFT
• Christian Morfaw, MD
• Jeremy Mork, MSW, LICSW
• Wanis Darwish Mousa
• Farhia Mursal, PHARM. D
• Megan B Naas, PA-C
• Wendy Haller Nerheim, APRN, CNP
• Christie Marissa Newman, DNP, APRN, FNP-BC
• Justin Robert Nicol, DPT

• Dentist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.