Angela Bulloch-Patterson, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012736 Issued in GA

Practice address

202 Calumet Center Rd
Lagrange, GA 30241-6712

Phone

(706) 298-0007

Fax

(706) 298-5008

NPI assigned

Mar 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1053444547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CALUMET CENTER RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416712",
            "telephone_number": "706-298-5007",
            "fax_number": "706-298-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CALUMET CENTER RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416712",
            "telephone_number": "706-298-0007",
            "fax_number": "706-298-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCH-PATTERSON",
        "first_name": "ANGELA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012736",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "588361758A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790594",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kela S Bryant, NP-C
• Btlcc Corp
• Kristie Lynn Buchanan, AGACNP-BC
• Saysha Buchanan
• Building Blocks Behavioral Center LLC
• Paige Busby
• Kitrina Bush, LPC
• Deborah Butler
• Emily Faith Butts, CPNP
• Steven Craig Butts, RPH

• Pediatric Dentistry in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.