Individual provider Active NPI

Andrew T Mueller, DDS

  • Dentist
  • Seattle, WA
National Provider Identifier
1538671979
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60775497 Issued in WA
Practice address
415 Boren Ave Apt 114
Seattle, WA 98104-2408
Phone
(208) 699-5432
NPI assigned
Oct 25, 2017
Last updated
Oct 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60775497 WA Primary

Addresses

Primary practice location

415 Boren Ave Apt 114
Seattle, WA 98104-2408

Mailing address

415 Boren Ave Apt 114
Seattle, WA 98104-2408
Phone (208) 699-5432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925002463 WA Order and Referring Only - DentistPractitioner - Dentist 7517408974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60775497WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1538671979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BOREN AVE APT 114",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042408",
            "telephone_number": "208-699-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BOREN AVE APT 114",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042408",
            "telephone_number": "208-699-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "ANDREW",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60775497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.