Active NPI
David McMullan, DDS
- Dentist
- Albuquerque, NM
National Provider Identifier
1992125488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30638
- Practice address
- 1801 Camino de Salud
Albuquerque, NM 87102 - Phone
- (505) 925-4031
- NPI assigned
- Apr 23, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30638 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | #TD-00-64 | NM |
Addresses
Primary practice location
1801 Camino de Salud
Albuquerque, NM 87102
Mailing address
824 Hewitt Drive Suite 300
Waco, TX 76712
Phone (254) 420-4211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 26, 2016 through Sep 26, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30638 | TX | MD | Dentist |
| #TD-00-64 | NM | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1992125488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 HEWITT DRIVE SUITE 300",
"city": "WACO",
"state": "TX",
"postal_code": "76712",
"telephone_number": "254-420-4211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 CAMINO DE SALUD",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87102",
"telephone_number": "505-925-4031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLAN",
"first_name": "DAVID",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-23",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30638",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": "#TD-00-64",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.