Juan J Ulloa, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

176 Issued in FL

Practice address

2815 16TH St SW
Minot, ND 58701-6914

Phone

(701) 857-2900

Fax

(701) 857-2910

NPI assigned

Jul 13, 2007

Last updated

May 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1811196504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5650",
            "fax_number": "701-857-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 16TH ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016914",
            "telephone_number": "701-857-2900",
            "fax_number": "701-857-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA",
        "first_name": "JUAN",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41434",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony A Udekwe, MD
• Chukwuka Ugobi
• David Ndubuisi Jude Ugobi, MD
• Crystal Ulat, CCC-SLP MA
• Tammy L Uleberg, NP
• Nicole A Underdahl, CRNA
• Unique Home Care LLC
• University of North Dakota (Center for Family Medicine Pharmacy)
• University of North Dakota (Center for Family Medicine - Minot)
• University of North Dakota (Center for Family Medicine Pharmacy)

• Oral and Maxillofacial Surgery (Dentist) in Minot, ND
• Providers in Minot, ND by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.