Joshua Bullock, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2020011311 Issued in MO

Practice address

1802 W Kearney St
Springfield, MO 65803-1647

Phone

(417) 567-8227

NPI assigned

Mar 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

State licenses

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.

• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1669474425
  Medicare reassignment NPD
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086
  NPD
• Moc Joplin, PLLC

  • Dentist
  • Joplin, MO
  • NPI 1265096325
  NPD (past)
• Moc Webb City, P L L C

  • Dentist
  • Webb City, MO
  • NPI 1013542232
  NPD (past)
• Springfield Kids Dental PLLC

  • Dentist
  • Springfield, MO
  • NPI 1336805753
  NPD (past)

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1245734508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832",
            "telephone_number": "620-231-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 W KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658031647",
            "telephone_number": "417-567-8227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3011 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "KS",
            "postal_code": "667622546",
            "country_code": "US",
            "telephone_number": "620-231-9873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JOSHUA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KS",
            "license": "61581",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2020011311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Buening, PT, DPT
• Sarah Buerck, MS, OTR/L
• Stan Dwane Buford, MS, NCC, PLCP, EMDR
• Kandise Buie, PHARMD, BCPS
• Ashley M. Bullard, PA-C
• Barbara A. Bumberry, MD
• John R. Bumberry, MD
• Frances H Bunch, LD
• Caitlin Nicole Burch
• Candace Leigh Burch, MS

• Pediatric Dentistry in Springfield, MO
• Providers in Springfield, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.