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DR. MIRANDA JOY MULLIGAN DDS
NPI 1073961157
Dentist in Shakopee, MN

Active since May 30, 2016PECOS Enrolled
250 FULLER ST. S., SUITE 250, SHAKOPEE, MN 55379(952) 445-6657(952) 445-0674 Get Directions Write a Review

NPPES record last updated: March 26, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Miranda Joy Mulligan Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MIRANDA JOY MULLIGAN DDS (NPI 1073961157) is an individual dentist in Shakopee, Minnesota, licensed in Minnesota (D13672) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073961157
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. MIRANDA JOY MULLIGANCredential: DDS
Location Address250 FULLER ST. S., SUITE 250Shakopee, MN 55379
Mailing Address250 Fuller St. S., Suite 250Shakopee, MN 55379 · (952) 445-6657 · Fax (952) 445-0674
Phone(952) 445-6657
Fax(952) 445-0674
Sole ProprietorNo
Enumeration DateMay 30, 2016
Last NPPES UpdateMarch 26, 2019
✔ NPI 1073961157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MN · D13672
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
250 FULLER ST. S., Shakopee, MN 55379
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Miranda Joy Mulligan Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Miranda Mulligan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

O'brien Dental Care
Same address
General Practice
250 FULLER ST S, SUITE 250
Shakopee, MN 55379
  • Reassigned Medicare billing, Minnesota enrollment
  • 4 clinicians in this Medicare group
NPI 1710086459 (952) 445-6657

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55379 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY MARIE MCMAHON DDS
Dentist
250 FULLER ST. S., SUITE 250
SHAKOPEE, MN 55379
Scott County (952) 445-6657

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miranda Mulligan's NPI number?

The NPI number for Miranda Mulligan is 1073961157. It was assigned to this individual provider in the NPPES registry on May 30, 2016.

Where is Miranda Mulligan located?

Miranda Mulligan practices at 250 Fuller St. S. Suite 250, Shakopee, MN 55379. The listed phone number is (952) 445-6657.

What is Miranda Mulligan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Miranda Mulligan enrolled in Medicare?

Yes. Miranda Mulligan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Miranda Mulligan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Miranda Mulligan reassigns Medicare benefits to O'brien Dental Care (Shakopee, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Miranda Mulligan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Miranda Mulligan accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Miranda Mulligan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Miranda Mulligan was last updated on March 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.