Jeannine Cullum DDS, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

18319 Issued in TX

Legal business name

JEANNINE CULLUM DDS, PLLC

Practice address

214 E Main St
San Augustine, TX 75972-2032

Phone

(936) 275-3101

Fax

(936) 275-1551

NPI assigned

Jun 6, 2012

Last updated

Jun 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeannine Cullum, DDSNPI 1407036072

Title

President

Phone

(936) 275-3101

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeannine Cullum, DDS

  • General Practice Dentistry
  • San Augustine, TX
  • NPI 1407036072
  NPD (past) Authorized official
• Wingett Harley Goodwin, DDS

  • General Practice Dentistry
  • San Augustine, TX
  • NPI 1568590578
  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1386905248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E MAIN ST",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759722032",
            "telephone_number": "936-275-3101",
            "fax_number": "936-275-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E MAIN ST",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759722032",
            "telephone_number": "936-275-3101",
            "fax_number": "936-275-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNINE CULLUM DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "CULLUM",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-275-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "18319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chivas Paul Guillote, APRN, FNP, AGACNP
• Health Opportunities for the People of East Texas, Inc. (Hope Pharmacy San Augustine)
• Hopkins County Hospital District (Stonecreek Nursing & Rehabilitation)
• Rebecca Hubbard, LAT, ATC
• Allison Nicole Jacks, LVN
• John H III & Sharon Oglesbee
• Konstant Kontact Services LLC
• Gregory Landerman
• Lisa Michelle Lane
• Charles K Layton, DDS

• Dental Clinic/Center in San Augustine, TX
• Providers in San Augustine, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.