Provider Demographics
NPI:1124914130
Name:MUELLER, JONATHAN PAUL (DDS)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PAUL
Last Name:MUELLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 HIGHWAY AA
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-9281
Mailing Address - Country:US
Mailing Address - Phone:573-846-6499
Mailing Address - Fax:
Practice Address - Street 1:1312 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2219
Practice Address - Country:US
Practice Address - Phone:785-841-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist