Provider Demographics
NPI:1023372877
Name:MULLINS, KARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:BLOBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:736 N 155TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1026 WOODBURY AVE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-7915
Practice Address - Country:US
Practice Address - Phone:712-847-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7333122300000X
MND13131122300000X
IA09376122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist