Individual provider Active NPI

Katie Jo Tulipano, DMD

  • Dentist
  • Bradenton, FL
National Provider Identifier
1174801708
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19327 Issued in FL
Practice address
2107 59TH St W
Bradenton, FL 34209
Phone
(941) 792-4153
Fax
(941) 794-6359
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19327 FL Primary

Addresses

Primary practice location

2107 59TH St W
Bradenton, FL 34209

Mailing address

400 Carillon Pkwy Ste 120
St Petersburg, FL 33716-1290
Phone (727) 229-0728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160203002432 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305140831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1174801708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CARILLON PKWY STE 120",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161290",
            "telephone_number": "727-229-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34209",
            "telephone_number": "941-792-4153",
            "fax_number": "941-794-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULIPANO",
        "first_name": "KATIE",
        "middle_name": "JO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.