Active NPI
Carol Judith McMullen, RDHAP
- Dental Hygienist
- San Diego, CA
National Provider Identifier
1356552624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 168
- Practice address
- 2118 Boundary St
San Diego, CA 92104 - Phone
- (619) 282-5322
- NPI assigned
- May 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 168 | CA | Primary |
Addresses
Primary practice location
2118 Boundary St
San Diego, CA 92104
Mailing address
2118 Boundary Street
San Diego, CA 92104
Phone (619) 282-5322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 523824 | Other | CA | DENTICAL PIN |
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 |
|---|---|---|---|
| 168 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356552624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2118 BOUNDARY STREET",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92104",
"telephone_number": "619-282-5322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2118 BOUNDARY ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92104",
"telephone_number": "619-282-5322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLEN",
"first_name": "CAROL",
"middle_name": "JUDITH",
"name_prefix": "Ms.",
"credential": "RDHAP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL PIN",
"identifier": "523824",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.