Alissa Nicole Pullos, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019032322 Issued in IL

Practice address

105 E 1St St Ste 103
Hinsdale, IL 60521

Phone

(630) 789-8070

NPI assigned

Apr 20, 2015

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apullos57539@direct.luhs.org

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

• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Oral and Maxillofacial Surgery Associates, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hinsdale, IL
  • NPI 1497808588
  NPD

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1043607872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E 1ST ST STE 103",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605214248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 1ST ST STE 103",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "630-789-8070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Albert Sabin Way",
            "address_2": "Holmes Hospital, room 2220",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452672800",
            "country_code": "US",
            "telephone_number": "513-584-2586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLOS",
        "first_name": "ALISSA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019032322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Edward Prohaska, LPC
• Donna Prost
• Daniel M Provencher, PA-C
• Angela Marie Prusa, ATC
• Cameron Krishon Pugh, PT, DPT
• Pulse Physical Therapy and Rehabilitation, LLC
• Abby Michelle Pyburn, ATC
• Maheen Ibadat Qadri, DO
• Fahad Qasim
• Syed Mohamed Ali Quadri, DO

• Oral and Maxillofacial Surgery (Dentist) in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.