Individual provider Active NPI

Gregory Jacob Tulachka, D.D.S., M.S.

  • Prosthodontics
  • Darlington, WI
National Provider Identifier
1902890445
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
3145-015 Issued in WI
Practice address
814 Clay St
Darlington, WI 53530-1228
Phone
(608) 776-4471
Fax
(608) 776-4311
NPI assigned
Sep 9, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 3145-015 WI Primary

Addresses

Primary practice location

814 Clay St
Darlington, WI 53530-1228

Mailing address

119 Nina Dr
Darlington, WI 53530-1607
Phone (608) 776-4650

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150421001132 WI Order and Referring Only - DentistPractitioner - Dentist 1456679588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3145-015WIMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902890445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 NINA DR",
            "city": "DARLINGTON",
            "state": "WI",
            "postal_code": "535301607",
            "telephone_number": "608-776-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 CLAY ST",
            "city": "DARLINGTON",
            "state": "WI",
            "postal_code": "535301228",
            "telephone_number": "608-776-4471",
            "fax_number": "608-776-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULACHKA",
        "first_name": "GREGORY",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WI",
            "license": "3145-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darlington, WI

Sources for this page

Verify at the official NPI Registry.