Healthcare Provider Details

I. General information

NPI: 1144236100
Provider Name (Legal Business Name): DAVID PAUL MUELLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 FIRST COLONIAL RD. SUITE 101
VIRGINIA BEACH VA
23454-3171
US

IV. Provider business mailing address

1157 FIRST COLONIAL RD STE 101
VIRGINIA BEACH VA
23454-2432
US

V. Phone/Fax

Practice location:
  • Phone: 757-496-8066
  • Fax: 757-496-8766
Mailing address:
  • Phone: 757-496-8066
  • Fax: 757-496-8766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number0438000177
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401007897
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0438000177
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: