Individual provider Active NPI

John M Romulus, DDS

  • General Practice Dentistry
  • Jacksonville, NC
National Provider Identifier
1720095201
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5368 Issued in NC
Practice address
306 Dolphin Dr Ste 1
Jacksonville, NC 28546-5266
Phone
(910) 455-3686
Fax
(910) 455-6394
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5368 NC Primary

Addresses

Primary practice location

306 Dolphin Dr Ste 1
Jacksonville, NC 28546-5266

Mailing address

306 Dolphin Dr Ste 1
Jacksonville, NC 28546-5266
Phone (910) 455-3686

Other names 1

  • John M Romulus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5368NCMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1720095201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 DOLPHIN DR STE 1",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465266",
            "telephone_number": "910-455-3686",
            "fax_number": "910-455-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 DOLPHIN DR STE 1",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465266",
            "telephone_number": "910-455-3686",
            "fax_number": "910-455-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMULUS",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "ROMULUS",
            "middle_name": "M",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.