Active NPI
Craig T Mueller, DDS
- Pediatric Dentistry
- Indianapolis, IN
National Provider Identifier
1841244803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12007703A
- Practice address
- 1121 W Michigan Street
Ds307B
Indianapolis, IN 46202-5186 - Phone
- (317) 278-3632
- Fax
- (317) 274-2603
- NPI assigned
- May 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 30.022221 | OH | |
| Pediatric Dentistry | 1223P0221X | 12007703A | IN | Primary |
Addresses
Primary practice location
1121 W Michigan Street
Ds307B
Indianapolis, IN 46202-5186
Mailing address
1121 W Michigan Street
Ds307B
Indianapolis, IN 46202-5186
Phone (317) 278-3632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150407000412 | IN | Order and Referring Only - Oral Surgery | 9234159781 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12007703A | IN | MD | Pediatric Dentist |
| 30.022221 | OH | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427846400000",
"number": "1841244803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 W MICHIGAN STREET",
"address_2": "DS307B",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025186",
"telephone_number": "317-278-3632",
"fax_number": "317-274-2603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 W MICHIGAN STREET",
"address_2": "DS307B",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025186",
"telephone_number": "317-278-3632",
"fax_number": "317-274-2603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "CRAIG",
"middle_name": "T",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2015-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "30.022221",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IN",
"license": "12007703A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.