Jonathon M. Pullara

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.031652 Issued in IL

Practice address

103 E Fountain St
Dodgeville, WI 53533-1749

Phone

(608) 935-5550

Fax

(608) 935-5168

NPI assigned

Jun 17, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jpullara1003325@direct.uwhealth.org

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

{
    "created_epoch": "1529193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1851885511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W BELTLINE HWY STE 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134231",
            "telephone_number": "608-443-5500",
            "fax_number": "608-441-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E FOUNTAIN ST",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331749",
            "telephone_number": "608-935-5550",
            "fax_number": "608-935-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLARA",
        "first_name": "JONATHON",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-17",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpullara1003325@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "103 E Fountain St",
            "city": "Dodgeville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535331749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy M Philipps, O.T.
• Jeff Pierce, CRNA
• Alan Piper, PT
• Karla R Pohlman, RDH
• Angela M Pomering, RDH
• John C Puls, LCSW
• Brianna L Quinn, LCSW
• Restoration Chiropractic, LLC
• Courtney Rae Reynolds
• Eric Ripley, PHARMD

• General Practice Dentistry in Dodgeville, WI
• Providers in Dodgeville, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.