Active NPI
William C Cullen, DMD
- General Practice Dentistry
- Ponte Vedra, FL
National Provider Identifier
1013110535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7894
- Practice address
- 100 Marketside Ave
Suite 306
Ponte Vedra, FL 32081-0582 - Phone
- (904) 770-4554
- NPI assigned
- Jun 11, 2007
- Last updated
- Jan 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7894 | FL | Primary |
Addresses
Primary practice location
100 Marketside Ave
Suite 306
Ponte Vedra, FL 32081-0582
Mailing address
100 Marketside Ave
Suite 306
Ponte Vedra, FL 32081-0582
Phone (904) 770-4554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7894 | FL | MD | Student in an Organized Health Care Education/Training Program |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388620800000",
"number": "1013110535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MARKETSIDE AVE",
"address_2": "SUITE 306",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320810582",
"telephone_number": "904-770-4554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARKETSIDE AVE",
"address_2": "SUITE 306",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320810582",
"telephone_number": "904-770-4554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLEN",
"first_name": "WILLIAM",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2014-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "7894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponte Vedra, FL
- Comfortable Care Dental Health Professionals, P.a. (Sawgrass Complete Dentistry)
- Connect RPM LLC
- Joseph A Contrino
- Nicole Catherine Coughlin
- Covenant Counseling Services Inc
- Daniel M Calloway MD PA
- Jill A Darnell, RPH
- Jorge Enrique De la Rotta Soto, APRN
- Joshua Michael Dearth, PA-C
- Carla Marie Defuria, MBA, RDN, LDN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.