Joseph Robert Bullock, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D5918 Issued in OR

Practice address

2825 NE West Devils Lake Rd
Lincoln City, OR 97367-5128

Phone

(541) 994-3033

Fax

(541) 994-6489

NPI assigned

Dec 12, 2011

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

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1134497639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 NE WEST DEVILS LAKE RD",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675128",
            "telephone_number": "541-994-3033",
            "fax_number": "541-994-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 NE WEST DEVILS LAKE RD",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675128",
            "telephone_number": "541-994-3033",
            "fax_number": "541-994-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JOSEPH",
        "middle_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D5918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Edward Bohlman, M.D.
• Dewayne C Bowman, DMD
• Matthew Richard Bowser, MD
• Stacey Lynn Brewer-Dally, RN
• Adriana Buer
• Caring for the Pacific LLC
• Angela M Carlson, APRN, PMHNP-BC
• Tina Marie Carlson, FNP-BC
• Gregory P. Carozza, D.O.
• Heather Braud Carter, RPH

• Dentist in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.