Individual provider Active NPI

Michael John Mulvehill III, DDS

  • General Practice Dentistry
  • Arcadia, CA
National Provider Identifier
1649370024
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24574 Issued in CA
Practice address
624 W Duarte Rd
Ste 204
Arcadia, CA 91007
Phone
(626) 447-0934
Fax
(626) 447-6405
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 24574 CA Primary

Addresses

Primary practice location

624 W Duarte Rd
Ste 204
Arcadia, CA 91007

Mailing address

624 W Duarte Rd
Ste 204
Arcadia, CA 91007
Phone (626) 447-0934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160108002373 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315830452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24574CAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Han Dental, Apc General Practice 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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649370024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD",
            "address_2": "STE 204",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91007",
            "telephone_number": "626-447-0934",
            "fax_number": "626-447-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD",
            "address_2": "STE 204",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91007",
            "telephone_number": "626-447-0934",
            "fax_number": "626-447-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVEHILL",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.