Dana W Mullis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

011878 Issued in GA

Practice address

1003 Plaza Ave
Eastman, GA 31023

Phone

(478) 374-1127

NPI assigned

Mar 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dana W Mullis DMD PC

  • Dentist
  • Eastman, GA
  • NPI 1417085184
  NPD (past) Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740318625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4098",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310234098",
            "telephone_number": "478-374-1127",
            "fax_number": "478-374-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "31023",
            "telephone_number": "478-374-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "DANA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "011878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00803151B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Middle Georgia Total Health Center, LLC
• Bart Steele Milner, P.A.
• Blake E Milner, M.D.
• Olubansile A Mimiko, M.D.
• Demetria Aries Mitchell
• Debbie Jones Mullis, LCSW
• James Michael Mullis
• Ocmulgee Family Medicine LLC.
• Ocmulgee Internal Medicine and Nephrology, LLC
• Ocmulgee Medical Services, LLC

• Dentist in Eastman, GA
• Providers in Eastman, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.