Matthew Mueller

Primary specialty

DentistTaxonomy code 122300000X

License

600105115 Issued in WI

Practice address

7137 236TH Ave Ste 108
Salem, WI 53168-8975

Phone

(262) 843-4643

NPI assigned

Aug 2, 2022

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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.

• Family & Restorative Dentistry

  dba Fulmer Dentistry

  • Dental Clinic/Center
  • Salem, WI
  • NPI 1497276729
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1740917590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E OKLAHOMA AVE UPPR UNIT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072403",
            "telephone_number": "920-530-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7137 236TH AVE STE 108",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531688975",
            "telephone_number": "262-843-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "600105115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Joy McClyman-Schmitt, OTR
• Kimberly Mecham, PTA
• Leigh Ann Miller, O.T.R.
• Nikolai S Miskov, DPT
• Jessica Monson
• Hannah Rose Naccarato, COTA
• Rachel D Novak, NP
• Soohyon Oh, PHARMD
• Olivine, S.C.
• Paddock Lake Family Practice, SC

• Dentist in Salem, WI
• Providers in Salem, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.