Active NPI
Lynn Andrew Mutch, DDS
- Dentist
- Alhambra, CA
National Provider Identifier
1568547693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 28771
- Practice address
- 1212 E Main Street
Suite 2
Alhambra, CA 91801-4113 - Phone
- (626) 282-2552
- Fax
- (626) 282-0111
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 28771 | CA | Primary |
Addresses
Primary practice location
1212 E Main Street
Suite 2
Alhambra, CA 91801-4113
Mailing address
1212 E Main Street
Suite 2
Alhambra, CA 91801-4113
Phone (626) 282-2552
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1568547693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 E MAIN STREET",
"address_2": "SUITE 2",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918014113",
"telephone_number": "626-282-2552",
"fax_number": "626-282-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 E MAIN STREET",
"address_2": "SUITE 2",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918014113",
"telephone_number": "626-282-2552",
"fax_number": "626-282-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTCH",
"first_name": "LYNN",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "28771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alhambra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.