Adrian Bertulfo

Primary specialty

DentistTaxonomy code 122300000X

License

36338 Issued in TX

Practice address

900 S Preston Rd
Prosper, TX 75078-5143

Phone

(469) 459-0403

NPI assigned

Jul 21, 2020

Last updated

Jul 14, 2022By 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 2

Addresses

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1104434695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 ADVENTUROUS SHIELD DR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565409",
            "telephone_number": "214-425-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S PRESTON RD",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750785143",
            "telephone_number": "469-459-0403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1739 N Central Expy Ste 100",
            "address_purpose": "LOCATION",
            "city": "McKinney",
            "state": "TX",
            "postal_code": "750703141",
            "country_code": "US",
            "telephone_number": "972-540-9191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTULFO",
        "first_name": "ADRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36338",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Logan Berlof, PT, DPT, CSCS
• Wendy Carolina Bernal
• Lisa Lee Besch, M.ED.
• Sharlaw Bhargava, M.D.
• Soumya Billa, MD
• Prathyusha Sathiandran Binu
• Brittani Birge

• Dentist in Prosper, TX
• Providers in Prosper, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.