NPIMap

Individual provider Active NPI

Michael Illar Muul, DDS, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, MD
National Provider Identifier
1508885682
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
10804 Issued in MD
Practice address
6798 Oak Hall LN
Suite A1
Columbia, MD 21045-4892
Phone
(410) 290-7757
Fax
(410) 290-8182
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 10804 MD Primary

Addresses

Primary practice location

6798 Oak Hall LN
Suite A1
Columbia, MD 21045-4892

Mailing address

6798 Oak Hall LN
Suite A1
Columbia, MD 21045-4892
Phone (410) 290-7757

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10804MDMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Oral Surgery, Inc. Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1508885682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6798 OAK HALL LN",
            "address_2": "SUITE A1",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454892",
            "telephone_number": "410-290-7757",
            "fax_number": "410-290-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6798 OAK HALL LN",
            "address_2": "SUITE A1",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454892",
            "telephone_number": "410-290-7757",
            "fax_number": "410-290-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUUL",
        "first_name": "MICHAEL",
        "middle_name": "ILLAR",
        "name_prefix": "Dr.",
        "credential": "DDS, PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "10804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.