Nicolette Ann Hecita Bulaon, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE61449731 Issued in WA

Practice address

16810 Meridian E Ste J107
Puyallup, WA 98375-9604

Phone

(253) 848-7777

NPI assigned

Jul 26, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• WA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington Dental Corporation PC

  • General Practice Dentistry
  • Puyallup, WA
  • NPI 1114324795
  NPD (past)
• Washington Dental Corporation, PC

  • General Practice Dentistry
  • Puyallup, WA
  • NPI 1417384348
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747526400000",
    "number": "1033890835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23000 MILITARY RD S APT 3324",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980321949",
            "telephone_number": "206-201-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16810 MERIDIAN E STE J107",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983759604",
            "telephone_number": "253-848-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULAON",
        "first_name": "NICOLETTE",
        "middle_name": "ANN HECITA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61449731",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61449731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Mae Buell, LMP
• Noelle Christine Buell, BS,MS,PT
• Suzanne Bea Buell, M.S.,P.T.
• Margaret Kyemba Bugonzi
• Marta Buhrii
• Jennifer Rae Bull, LMP
• Nina Bullard
• Karla Bullen, LMP
• C. Kevin Bulley, M.D.
• Bunce Rental, Inc

• Dentist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.