William Lawrence Hull III, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12013087A Issued in IN

Practice address

3367 Douglas Rd
South Bend, IN 46635-1779

Phone

(574) 272-8823

Fax

(574) 277-1837

NPI assigned

Aug 2, 2010

Last updated

Dec 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 16, 2015 through Feb 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: whull1158619@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edison Lakes Oral Surgery, P.C.

  dba Oral Surgery Michiana

  • Oral and Maxillofacial Surgery Clinic/Center
  • South Bend, IN
  • NPI 1881887065
  NPD
• Oral Facial Surgery Institute, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mesa, AZ
  • NPI 1508758657
  NPD (past)

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1639483647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3367 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351779",
            "telephone_number": "574-272-8823",
            "fax_number": "574-277-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3367 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351779",
            "telephone_number": "574-272-8823",
            "fax_number": "574-277-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "WILLIAM",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-02",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12013087A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody L. Hughes, LCSW
• Thomas Anderson Hughes, MD
• Philip Paul Hulecki, DDS
• Rayne Hulitt, RBT
• Sally Elizabeth Hull, NP
• Joseph Hulse Jr., NP
• Humbly Changing LLC
• Sarah Sue Humes, FNP
• Alexis Humphries, RBT
• Erin Eileen Hunt, MS, LAT, ATC

• Oral and Maxillofacial Surgery (Dentist) in South Bend, IN
• Providers in South Bend, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.