Provider Demographics
NPI:1144236100
Name:MUELLER, DAVID PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:MUELLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1157 FIRST COLONIAL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2432
Mailing Address - Country:US
Mailing Address - Phone:757-496-8066
Mailing Address - Fax:757-496-8766
Practice Address - Street 1:1157 FIRST COLONIAL RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3171
Practice Address - Country:US
Practice Address - Phone:757-496-8066
Practice Address - Fax:757-496-8766
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04380001771223P0106X, 1223S0112X
VA0401007897122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA244947OtherANTHEM BC/BS
VA15477OtherOPTIMA HEALTH INS
VA828056OtherUNITED CONCORDIA INS
VA828056OtherUNITED CONCORDIA INS