Evan M Buller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30018820 Issued in OH

Practice address

510 Superior Ave
Cleveland, OH 44114

Phone

(216) 621-3675

Fax

(216) 621-9790

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Care Alliance

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1023406469
  NPD (past)
• Care Alliance

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1396874426
  NPD (past)
• Schermer Haynes & Associates DDS Inc

  • Dentist
  • Cleveland, OH
  • NPI 1477764835
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508946435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44114",
            "telephone_number": "216-621-3675",
            "fax_number": "216-621-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44114",
            "telephone_number": "216-621-3675",
            "fax_number": "216-621-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLER",
        "first_name": "EVAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30018820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0782532",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Blake Buletko
• Jason Anthony Joseph Bulgin Sr.
• Cecilia Bulgrin
• David S Bullard, MD
• Katherine Bullard
• Benjamin D Bullimore, NP
• Danielle Samone Bullock-Mowoh, MD
• Adam Paul Bullock
• Elisabeth Bullock, COTA/L
• Elizabeth Lynn Bullock, MT-BC

• General Practice Dentistry in Cleveland, OH
• Providers in Cleveland, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.