NPIMap

Organization Active NPI

Singh Bullard Pediatric Dentistry, PC

Doing business as Noblesville Kids Dentistry

  • Dentist
  • Noblesville, IN
National Provider Identifier
1750794269
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12010489B Issued in IN
Legal business name
SINGH BULLARD PEDIATRIC DENTISTRY, PC
Doing business as
Noblesville Kids Dentistry
Practice address
9669 E 146TH St
Noblesville, IN 46060-5005
Phone
(317) 773-5437
Fax
(317) 773-3565
NPI assigned
Jun 3, 2014
Last updated
Jun 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Authorized official

Name
Dr. Samuel Bullard, DDS, MSD
Title
Doctor
Phone
(317) 219-8684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12010489B IN Primary

Addresses

Primary practice location

9669 E 146TH St
Noblesville, IN 46060-5005

Mailing address

9669 E 146TH St
Noblesville, IN 46060-5005
Phone (317) 773-5437

Other identifiers 1

IdentifierTypeStateIssuer
20051740AMedicaidIN

Other names 1

  • Noblesville Kids Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Noblesville Kids Dentistry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1750794269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 E 146TH ST",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460605005",
            "telephone_number": "317-773-5437",
            "fax_number": "317-773-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 E 146TH ST",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460605005",
            "telephone_number": "317-773-5437",
            "fax_number": "317-773-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SINGH BULLARD PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "317-219-8684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010489B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20051740A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noblesville Kids Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.