Provider Demographics
NPI:1609552819
Name:MUELLER, KATHRYN (DMD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13375 N 92ND WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4300
Mailing Address - Country:US
Mailing Address - Phone:650-815-8033
Mailing Address - Fax:
Practice Address - Street 1:23271 N SCOTTSDALE RD STE A106
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4484
Practice Address - Country:US
Practice Address - Phone:480-544-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011804122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist