Brandon McCullough, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103193 Issued in CA

Practice address

210 S Montclair St
Bakersfield, CA 93309-3164

Phone

(661) 397-0665

NPI assigned

Sep 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Locations

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.

• Brandon McCullough Dental Corporation

  dba Masterworks Dentistry

  • Dentist
  • Bakersfield, CA
  • NPI 1548866445
  NPD Authorized official

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1245713197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S. MONTCLAIR ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93309",
            "telephone_number": "210-240-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MONTCLAIR ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933093164",
            "telephone_number": "661-397-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "BRANDON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103193",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josette McCrary
• Edward John McCrink III, DO
• Geocel-Grace Castanares McCrink, DO
• Noah McCullah
• Melissa Joy McCullar
• Stephanie McCullough
• Alexandra Nicole McCullum
• Kelly McCurrie, CADC II
• Deborah Lynn McDade
• Nathaniel John McDanel

• General Practice Dentistry in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.