Healthcare Provider Details
I. General information
NPI: 1437942463
Provider Name (Legal Business Name): JOSEPH MULLEN, DDS, MS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1240 S WESTLAKE BLVD STE 235
WESTLAKE VILLAGE CA
91361-6202
US
IV. Provider business mailing address
1240 S WESTLAKE BLVD STE 235
WESTLAKE VILLAGE CA
91361-6202
US
V. Phone/Fax
- Phone: 805-496-9778
- Fax:
- Phone: 805-496-9778
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSEPH
MULLEN
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 916-770-9035