Provider Demographics
NPI:1346842309
Name:STEPHANIE L MULLINS DDS MS LLC
Entity Type:Organization
Organization Name:STEPHANIE L MULLINS DDS MS LLC
Other - Org Name:STEPHANIE L. MULLINS, DDS MS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:3470 NE RALPH POWELL RD STE C
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2330
Mailing Address - Country:US
Mailing Address - Phone:816-524-9800
Mailing Address - Fax:
Practice Address - Street 1:3470 NE RALPH POWELL RD STE C
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2330
Practice Address - Country:US
Practice Address - Phone:816-524-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty