Organization Active NPI

Precision Dental Specialties PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • St George, UT
National Provider Identifier
1912766882
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
PRECISION DENTAL SPECIALTIES PLLC
Practice address
754 S Main St Ste 5
St George, UT 84770-5519
Phone
(435) 652-1445
NPI assigned
Mar 14, 2024
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Brandon Scott Bulloch, DDS,MS
Title
Doctor
Phone
(435) 652-1445

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

754 S Main St Ste 5
St George, UT 84770-5519

Mailing address

754 S Main St Ste 5
St George, UT 84770-5519
Phone (435) 652-1445

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1912766882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 S MAIN ST STE 5",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705519",
            "telephone_number": "435-652-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 S MAIN ST STE 5",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705519",
            "telephone_number": "435-652-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION DENTAL SPECIALTIES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "BULLOCH",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "435-652-1445",
        "authorized_official_credential": "DDS,MS"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.