Individual provider Active NPI

Ray Michael McCullough, DDS

  • Dentist
  • Spring Hill, FL
National Provider Identifier
1205996428
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN17434 Issued in FL
Practice address
7551 Forest Oaks Blvd
Spring Hill, FL 34606-2437
Phone
(352) 518-2000
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17434 FL
Dentist 122300000X DN17434 FL Primary

Addresses

Primary practice location

7551 Forest Oaks Blvd
Spring Hill, FL 34606-2437

Mailing address

29743 Chapel Park Dr
Wesley Chapel, FL 33543-4491
Phone (813) 849-3508

Other practice location 1

13146 US Highway 301 S
Riverview, FL 33569-7410
Phone (813) 672-9575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN17434FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1205996428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29743 CHAPEL PARK DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335434491",
            "telephone_number": "813-849-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 FOREST OAKS BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346062437",
            "telephone_number": "352-518-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13146 US Highway 301 S",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335697410",
            "country_code": "US",
            "telephone_number": "813-672-9575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "RAY",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17434",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.