John a. Bullock DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JOHN A. BULLOCK DMD LLC

Doing business as

Bullock Family Dental

Practice address

18813 SW Martinazzi Ave
Tualatin, OR 97062-6807

Phone

(503) 691-9400

Fax

(503) 691-9439

NPI assigned

May 23, 2009

Organization subpart

No

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

Authorized official

Name

Dr. John A Bullock, DMD

Title

Managing Member

Phone

(503) 691-9400

Specialties & licenses 1

Addresses

Other names 1

• Bullock Family Dental Doing business as

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

{
    "created_epoch": "1243036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243036800000",
    "number": "1467687137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18813 SW MARTINAZZI AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626807",
            "telephone_number": "503-691-9400",
            "fax_number": "503-691-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18813 SW MARTINAZZI AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626807",
            "telephone_number": "503-691-9400",
            "fax_number": "503-691-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A. BULLOCK DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-23",
        "last_updated": "2009-05-23",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-691-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bullock Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremiah C. Murphy, M.D., PC
• Kaitlin Emily Jernstedt
• Jfi Holding, LLC (Occupational Orthopedics, LLC)
• Jimmy Huebert MD Inc
• JLS Surgical First Assistants LLC
• Bryan Johnson, D.D.S., M.S.
• Jason J Johnson, RN
• Joan M Johnson, OT
• Sharon Johnston, RN
• Sabrina F Jones-Wyatt, BSN, RN

• Dental Clinic/Center in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2009; 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.