Active NPI
George James Gulu Sr., DDS
- Dentist
- Columbus, OH
National Provider Identifier
1982653853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17790
- Practice address
- 2079 Eakin Rd
Columbus, OH 43223-3294 - Phone
- (614) 274-8500
- Fax
- (614) 274-9687
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17790 | OH | Primary |
Addresses
Primary practice location
2079 Eakin Rd
Columbus, OH 43223-3294
Mailing address
6563 Deeside Dr
Dublin, OH 43017-9457
Phone (614) 761-2968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150107002173 | OH | Order and Referring Only - Oral Surgery | 5799008207 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17790 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188864000000",
"number": "1982653853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6563 DEESIDE DR",
"city": "DUBLIN",
"state": "OH",
"postal_code": "430179457",
"telephone_number": "614-761-2968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2079 EAKIN RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432233294",
"telephone_number": "614-274-8500",
"fax_number": "614-274-9687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULU",
"first_name": "GEORGE",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2007-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "17790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.