Provider Demographics
NPI:1811058449
Name:MUELLER, JENNIFER REED (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:REED
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002-0810
Mailing Address - Country:US
Mailing Address - Phone:804-561-2146
Mailing Address - Fax:804-561-2239
Practice Address - Street 1:16320 GOODES BRIDGE RD.
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:VA
Practice Address - Zip Code:23002
Practice Address - Country:US
Practice Address - Phone:804-561-2146
Practice Address - Fax:804-561-2239
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014100751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice