JOHN A. BULLOCK DMD LLC (NPI# 1467687137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467687137 |
| Entity Type | Organization |
| Organization Name | JOHN A. BULLOCK DMD LLC |
| Other Organization Name | BULLOCK FAMILY DENTAL |
| Practice Address |
18813 Sw Martinazzi Ave Tualatin OR 97062-6807 |
| Practice Telephone | 5036919400 |
| Practice Fax Number | 5036919439 |
| Mailing Telephone | 5036919400 |
| Mailing Fax Number | 5036919439 |
| Enumeration Date | 2009-05-23 |
| Last Update Date | 2009-05-23 |
| Authorized Official Name | DR. JOHN A BULLOCK (MANAGING MEMBER) |
| Authorized Official Telephone | 5036919400 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bullock Family Dental | Doing Business As Name - Organization |
| Street Address |
18813 SW MARTINAZZI AVE |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-6807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033741103 | Claudia Raquel Perfecto | Acupuncturist | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2020-02-06 |
| 1255996633 | Jennifer Poindexter Nd LLC | Clinic/Center | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2019-05-01 |
| 1285006478 | Ashley Lauren Brauker | Naturopath | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2015-10-27 |
| 1184037905 | Lisa Pendleton | Massage Therapist | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2014-06-10 |
| 1134558976 | Hale Health, LLC | Clinic/Center | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2013-11-02 |
| 1316375439 | Kathryn Brooks | Naturopath | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2013-10-29 |
| 1992132906 | Constance Lillian Erickson | Naturopath | 18813 Sw Martinazzi Ave, Tualatin, OR 97062-6807 | 2013-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255762449 | Tualatin Pediatric Dentistry | Clinic/Center | 18803 Sw Boones Ferry Rd, Suite 5, Tualatin, OR 97062-8412 | 2013-12-12 |
| 1790942779 | Bill Jordan, Dmd, PC | Clinic/Center | 18789 Sw Boones Ferry Rd, Tualatin, OR 97062-8412 | 2008-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834375 | Geoffrey R Clive Dds LLC | Clinic/Center | 11082 Se Oak St, Milwaukie, OR 97222-6692 | 2020-09-04 |
| 1508416041 | Columbia River Dentistry-gresham, LLC | Clinic/Center | 1700 Nw Civic Dr Ste 320, Gresham, OR 97030-3774 | 2019-09-17 |
| 1063065068 | Portland Dental Smiles | Clinic/Center | 732 Sw 3rd Ave Ste 202, Portland, OR 97204-2409 | 2019-07-18 |
| 1104478619 | David A Allen Dds | Clinic/Center | 1059 Royal Ave, Medford, OR 97504-6127 | 2019-07-15 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1164080875 | Central Point Dental LLC | Clinic/Center | 12338 Se 143rd Pl, Happy Valley, OR 97086-6545 | 2019-05-29 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1558839498 | Kevin Prates Dds, PC | Clinic/Center | 1002 10th St Ste 1, Hood River, OR 97031-1564 | 2018-11-08 |
| 1063993749 | Roots Dental Stark LLC | Clinic/Center | 16338 Se Stark St, Portland, OR 97233-3958 | 2018-08-22 |
| 1528546330 | Christopher Brady Dmd LLC | Clinic/Center | 4707 Ne 102nd Ave Ste A, Portland, OR 97220-3393 | 2018-08-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.