Active NPI
Bettina Bullard
- Dental Hygienist
- Maxton, NC
National Provider Identifier
1306298609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 7515
- Practice address
- 773 John L Rd
Maxton, NC 28364-8843 - Phone
- (910) 740-0113
- NPI assigned
- Jul 11, 2016
- Last updated
- Jul 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 7515 | NC | Primary |
Addresses
Primary practice location
773 John L Rd
Maxton, NC 28364-8843
Mailing address
3718 Gruber Rd
Fort Bragg, NC 28310-8934
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1306298609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3718 GRUBER RD",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283108934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "773 JOHN L RD",
"city": "MAXTON",
"state": "NC",
"postal_code": "283648843",
"telephone_number": "910-740-0113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLARD",
"first_name": "BETTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NC",
"license": "7515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maxton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.