Individual provider Active NPI

Julia Tullos Gildon, D.D.S.

  • Dentist
  • Little Rock, AR
National Provider Identifier
1689864498
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3630 Issued in AR
Practice address
5 Van Cir
Little Rock, AR 72207-5211
Phone
(501) 664-5615
Fax
(501) 664-9118
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3630 AR Primary

Addresses

Primary practice location

5 Van Cir
Little Rock, AR 72207-5211

Mailing address

5 Van Cir
Little Rock, AR 72207-5211
Phone (501) 664-5615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20150603002320 AR Order and Referring Only - DentistPractitioner - Dentist 3173844057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3630ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Roy R Jolley DDS Past Accepting new patients
Julia T. Gildon, D.D.S., PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1689864498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 VAN CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075211",
            "telephone_number": "501-664-5615",
            "fax_number": "501-664-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 VAN CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075211",
            "telephone_number": "501-664-5615",
            "fax_number": "501-664-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDON",
        "first_name": "JULIA",
        "middle_name": "TULLOS",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.