Individual provider Active NPI

Emily Hodges Buller

  • Dentist
  • Mamou, LA
National Provider Identifier
1205216835
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6584 Issued in LA
Practice address
908 6TH St
Mamou, LA 70554-3122
Phone
(337) 468-2787
NPI assigned
Jun 9, 2015
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6584 LA Primary

Addresses

Primary practice location

908 6TH St
Mamou, LA 70554-3122

Mailing address

908 6TH St
Mamou, LA 70554-3122
Phone (337) 468-2787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160422001977 LA Order and Referring Only - DentistPractitioner - Dentist 6305145483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6584LAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Buller Family Dentistry LLC Past Accepting new patients
Prentiss a. Perkins, D.D.S. Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1205216835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 6TH ST",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "705543122",
            "telephone_number": "337-468-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 6TH ST",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "705543122",
            "telephone_number": "337-468-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLER",
        "first_name": "EMILY",
        "middle_name": "HODGES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamou, LA

Sources for this page

Verify at the official NPI Registry.