NPIMap

Organization Active NPI

Rex L. Bullock DDS Inc

  • General Practice Dentistry
  • Corona, CA
National Provider Identifier
1720190226
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25370 Issued in CA
Legal business name
REX L. BULLOCK DDS INC
Practice address
914 Washburn Ave
Ste #2
Corona, CA 92882-4362
Phone
(951) 737-1149
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rex Bullock, DDSNPI 1386755114
Title
Dentist
Phone
(951) 737-1149

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 25370 CA Primary

Addresses

Primary practice location

914 Washburn Ave
Ste #2
Corona, CA 92882-4362

Mailing address

914 Washburn Ave
Ste #2
Corona, CA 92882-4362

National Provider Directory

National Provider Directory

Locations

914 Washburn Ave
Ste 2
Corona, CA 92882
Phone (951) 737-1149

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720190226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 WASHBURN AVE",
            "address_2": "STE #2",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928824362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 WASHBURN AVE",
            "address_2": "STE #2",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928824362",
            "telephone_number": "951-737-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REX L. BULLOCK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "951-737-1149",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.