Individual provider Active NPI

Iris Garcia Bullard, DMD

  • Dentist
  • Atlanta, GA
National Provider Identifier
1710325451
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN015820 Issued in GA
Practice address
3167 Peachtree Rd NE Ste a
Atlanta, GA 30305-1812
Phone
(678) 941-5435
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20114 FL
Dentist 122300000X DN015820 GA Primary

Addresses

Primary practice location

3167 Peachtree Rd NE Ste a
Atlanta, GA 30305-1812

Mailing address

1857 Canmont Dr NE
Brookhaven, GA 30319-3617
Phone (904) 742-5507

Other names 1

  • Dr. Iris C Garcia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160802002475 FL Order and Referring Only - DentistPractitioner - Dentist 7113211962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN20114FLMDDentist
DN015820GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, PA Past Accepting new patients

Organizations & group practices 1

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1710325451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 CANMONT DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193617",
            "telephone_number": "904-742-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3167 PEACHTREE RD NE STE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051812",
            "telephone_number": "678-941-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA BULLARD",
        "first_name": "IRIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20114",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRIS",
            "last_name": "GARCIA",
            "middle_name": "C",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.