Active NPI
Brandon Hull, D.M.D., M.S.
- Dentist
- Rockford, IL
National Provider Identifier
1225209562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019027462
- Practice address
- 1055 Featherstone Rd
Ste. B
Rockford, IL 61107-5904 - Phone
- (815) 227-5858
- NPI assigned
- Mar 14, 2008
- Last updated
- May 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019027462 | IL | Primary |
| Periodontics | 1223P0300X | 021002370 | IL |
Addresses
Primary practice location
1055 Featherstone Rd
Ste. B
Rockford, IL 61107-5904
Mailing address
1055 Featherstone Rd
Ste. B
Rockford, IL 61107-5904
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6902 | WI | MD | Clinical Social Worker |
| 021002370 | IL | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Periodontics & Implants | Periodontics | Past | Accepting new patients |
| Anthony E. Urlakis DDS., SC | 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.
-
- Periodontics
- Palatine, IL
- NPI 1235267469
-
- Dental Clinic/Center
- Janesville, WI
- NPI 1689899197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431043200000",
"number": "1225209562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 FEATHERSTONE RD",
"address_2": "STE. B",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611075904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 FEATHERSTONE RD",
"address_2": "STE. B",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611075904",
"telephone_number": "815-227-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HULL",
"first_name": "BRANDON",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-14",
"last_updated": "2015-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019027462",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IL",
"license": "021002370",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.