Brandon Scott Bulloch, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

28 Issued in AR

Practice address

3394 N Futrall Dr Ste 2
Fayetteville, AR 72703-3937

Phone

(479) 582-3360

NPI assigned

Apr 6, 2022

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 UT

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

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1336880913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3394 N FUTRALL DR STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033937",
            "telephone_number": "479-582-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3394 N FUTRALL DR STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033937",
            "telephone_number": "479-582-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCH",
        "first_name": "BRANDON",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4795",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "AR",
            "license": "28",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lonna Shay Bufford, MD
• Building Bridges Therapy Center
• Kamlesh V Bulchandani, MD
• Natalie Bules, RD, LD
• Kati L. Bullington, OT
• Mary Elizabeth Bullock-Rest, PHD
• Kirstin Bump
• Cara L Burcham, OT
• Casey Ann Burd
• Margaret Adams Burge, B.S.,M.A.T., M.S.W

• Prosthodontics in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Prosthodontics in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.