Gus Pulos, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

120008816 Issued in IN

Practice address

1002 N Mitthoeffer Rd
Suite B
Indianapolis, IN 46229-2461

Phone

(317) 898-6666

Fax

(317) 898-4965

NPI assigned

Mar 27, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• Eastpointe Family Dentistry, LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1801649637
  NPD (past)
• Pulos Family Dentistry, LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1972016392
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1184743890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N MITTHOEFFER RD",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292461",
            "telephone_number": "317-898-6666",
            "fax_number": "317-898-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N MITTHOEFFER RD",
            "address_2": "SUITE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292461",
            "telephone_number": "317-898-6666",
            "fax_number": "317-898-4965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULOS",
        "first_name": "GUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "120008816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "351688238",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Elizabeth Pullicino, PSYD
• Pulmonary Clinical Solutions Indiana, LLC
• Pulmonary Medical Associates, P.C.
• Pulos Family Dentistry, LLC
• Emily Pulos
• Kelsey M Pumel, BCBA
• Mrudula B Punjani, MSW
• Aileen Feliza Puno, MD
• Meganne Punt
• Jyoti Pupneja

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.