Individual provider Active NPI

Britney Pulliam, DMD

  • General Practice Dentistry
  • Conyers, GA
National Provider Identifier
1750909941
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN016104 Issued in GA
Practice address
2239 Highway 20 SE Ste H
Conyers, GA 30013-2087
Phone
(770) 921-3565
NPI assigned
Jul 14, 2020
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 DN016104 GA Primary

Addresses

Primary practice location

2239 Highway 20 SE Ste H
Conyers, GA 30013-2087

Mailing address

2239 Highway 20 SE Ste H
Conyers, GA 30013-2087
Phone (770) 921-3565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210211002736 GA Order and Referring Only - DentistPractitioner - Dentist 7012322613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Decatur Dentistry, PC General Practice Past Accepting new patients
Conyers Smiles Dentistry, PC General Practice PastSince Jul 27, 2020 Accepting new patients
Woodstock Dentistry, PC General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1750909941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 HIGHWAY 20 SE STE H",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132087",
            "telephone_number": "770-921-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 HIGHWAY 20 SE STE H",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132087",
            "telephone_number": "770-921-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "BRITNEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN016104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.