Jeremy Wade Cull, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7170 Issued in AZ

Practice address

1876 E Sabin Drive Suite #18
Casa Grande, AZ 85222

Phone

(520) 876-5227

Fax

(520) 876-4059

NPI assigned

Jun 18, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 27, 2024 through Feb 27, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1104021476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 E SABIN DR",
            "address_2": "STE 6",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226197",
            "telephone_number": "520-876-5227",
            "fax_number": "520-423-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1876 E SABIN DRIVE SUITE #18",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85222",
            "telephone_number": "520-876-5227",
            "fax_number": "520-876-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULL",
        "first_name": "JEREMY",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "7170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Blessings LLC
• David Roger Crosby, DMD
• Crossroads Church (Charli's House)
• Bernadette Marie Crovedi, NP-C
• Jose Cuestas III, RPH
• Cygnet Academy LLC
• D Michael Dick, P.C.
• Darlene Doris Daniels
• Melissa Dasher, RN
• Germaine Davenport, CDM CFPP SNS CPFM

• Oral and Maxillofacial Surgery (Dentist) in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.