Dane Parke Mullinax, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

9317729 Issued in UT

Practice address

831 S 700 E
Salt Lake City, UT 84102-3505

Phone

(801) 691-6463

NPI assigned

Mar 30, 2016

Sex

Male

Sole proprietor

Yes

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 UT

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

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1780047670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023505",
            "telephone_number": "801-691-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023505",
            "telephone_number": "801-691-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINAX",
        "first_name": "DANE",
        "middle_name": "PARKE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "9317729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley R. Mulligan, MD
• Matthew James Mulligan, MD
• Lawerence Stafford Mullin
• Shantel Marie Mullin, PHARMD
• Thomas Robert Mullin, PHD
• John J Mulroy Jr., MD
• Philippa Morgan Mulryan, RPH
• Lynn Marie Mulvihill, RD
• Sean Jordan Mulvihill, MD
• Olivier Mutah Mulyangote, P.A.

• Dentist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.