Individual provider Active NPI

Eugene V Mueller, D.D.S.

  • Dentist
  • Davenport, IA
National Provider Identifier
1649341504
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5711 Issued in IA
Practice address
2228 Hickory Grove Rd
Davenport, IA 52804-2353
Phone
(563) 324-0212
Fax
(563) 322-7106
NPI assigned
Nov 13, 2006
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5711 IA Primary

Addresses

Primary practice location

2228 Hickory Grove Rd
Davenport, IA 52804-2353

Mailing address

2228 Hickory Grove Rd
Davenport, IA 52804-2353
Phone (563) 324-0212

Other identifiers 1

IdentifierTypeStateIssuer
0064691MedicaidIA

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

LicenseStateTypeSpecialty
5711IAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1649341504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 HICKORY GROVE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042353",
            "telephone_number": "563-324-0212",
            "fax_number": "563-322-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 HICKORY GROVE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042353",
            "telephone_number": "563-324-0212",
            "fax_number": "563-322-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "EUGENE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "5711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064691",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.