NPIMap

Organization Active NPI

Bullard Dental

  • Dentist
  • Martinez, GA
National Provider Identifier
1528412707
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014101 Issued in GA
Legal business name
BULLARD DENTAL
Practice address
3702 Washington Rd
Martinez, GA 30907-2848
Phone
(706) 863-5337
Fax
(706) 855-8249
NPI assigned
Apr 14, 2016
Last updated
Apr 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Dr. Jonathan L Bullard, DRNPI 1578862777
Title
Dentist
Phone
(706) 863-5337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014101 GA Primary

Addresses

Primary practice location

3702 Washington Rd
Martinez, GA 30907-2848

Mailing address

3702 Washington Rd
Martinez, GA 30907-2848
Phone (706) 863-5337

National Provider Directory

National Provider Directory

Locations

3702 Washington Rd
Martinez, GA 30907
Phone (706) 863-5337

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1528412707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 WASHINGTON RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072848",
            "telephone_number": "706-863-5337",
            "fax_number": "706-855-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 WASHINGTON RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072848",
            "telephone_number": "706-863-5337",
            "fax_number": "706-855-8249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLARD DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "706-863-5337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.

Verify at the official NPI Registry.