Wiebke Bultman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47048 Issued in CA

Practice address

1501 Superior Avenue, Suite 100
Newport Beach, CA 92663

Phone

(949) 650-6772

Fax

(949) 645-5701

NPI assigned

Aug 9, 2010

Last updated

Aug 9, 2010By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13534/brand/1/csg/1/fhir/r4

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.

• Liviu Gold D.D.S., Inc.

  dba Newport Beach Dental Associates

  • Dentist
  • Newport Beach, CA
  • NPI 1780721050
  NPD (past)

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1821303348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVENUE, SUITE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-650-6772",
            "fax_number": "949-645-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVENUE, SUITE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-650-6772",
            "fax_number": "949-645-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULTMAN",
        "first_name": "WIEBKE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Bui
• Thanhmy Nguyen Bui, MD
• Tien Ngoc My Bui
• Lynda Buitrago, MS
• Lisa M Bukaty, MD
• Jill Anne Bunney, NP
• John Buoncristiani, DDS
• Burak M. Ozgur, M.D., Incorporated
• Ashley Burbach
• Gianfranco Burdi, M.D.

• General Practice Dentistry in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.