Individual provider Active NPI

Brandon Hull, D.M.D., M.S.

  • Dentist
  • Rockford, IL
National Provider Identifier
1225209562
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027462 Issued in IL
Practice address
1055 Featherstone Rd
Ste. B
Rockford, IL 61107-5904
Phone
(815) 227-5858
NPI assigned
Mar 14, 2008
Last updated
May 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
6902WIMDClinical Social Worker
021002370ILMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.