Jaime NMN Bulkacz, DDS PHD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

32278 Issued in CA

Practice address

18740 Ventura Blvd
Suite 306
Tarzana, CA 91356

Phone

(818) 609-8655

Fax

(818) 609-8644

NPI assigned

Feb 28, 2006

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1831165828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18740 VENTURA BLVD",
            "address_2": "SUITE 306",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-609-8655",
            "fax_number": "818-609-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18740 VENTURA BLVD",
            "address_2": "SUITE 306",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-609-8655",
            "fax_number": "818-609-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULKACZ",
        "first_name": "JAIME",
        "middle_name": "NMN",
        "name_prefix": "Dr.",
        "credential": "DDS  PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "32278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniella Brown, MPT
• Karina Brown
• Kelly Brown
• Tasha Bruer
• Logan Buchholz
• Charles Park Burchette
• Serghei Burcovschii, MD
• Brittany Lynn Burgess
• Alexandra Burke, MA, AMFT
• Michael H Burnam, MD

• Periodontics in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.