Individual
DR. LISA KAY MULKIN
Active
Individual
DR. LISA KAY MULKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
050514-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
050514-1
NY
1223X2210X
Orofacial Pain Dentistry
050514-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050514
NEW YORK STATE LICENSE
NY
01
—
70455LM
BC/BS PROVIDER NUMBER
NY
Enumeration date
08/30/2006
Last updated
03/07/2023
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