John A Bullock, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7370 Issued in OR

Practice address

9415 SW Wilsonville Rd
Wilsonville, OR 97070-7522

Phone

(503) 691-9400

Fax

(503) 855-4689

NPI assigned

Oct 21, 2008

Last updated

Sep 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OR

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

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.

• John a. Bullock DMD LLC

  dba Bullock Family Dental

  • Dental Clinic/Center
  • Tualatin, OR
  • NPI 1467687137
  Authorized official Same address or phone

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1083866248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 SW WILSONVILLE RD",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970707522",
            "telephone_number": "503-682-0431",
            "fax_number": "503-682-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 SW WILSONVILLE RD",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970707522",
            "telephone_number": "503-691-9400",
            "fax_number": "503-855-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Wangsgard Brown, OTR
• Caitlin Ashley Bruns
• Rachael Alana Bubeck, COTA
• Madeleine Bucci
• Andrew James Buchele, MA
• Melodie Dawn Burdette, PHYSICAL THERAPIST
• Margaret Burkes, ND
• Burley Endodontics, LLC (Wilsonville Endodontics)
• Stephanie Bushbaum
• Martha Butler

• General Practice Dentistry in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.