DR. JUSTIN TULLIS D.D.S NPI 1497115752

NPI Information

NPI: 1497115752
Provider Name: DR. JUSTIN TULLIS, D.D.S
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

PECOS Registration: Yes

Address:
320 E FONTANERO ST STE 307
COLORADO SPRINGS, CO
ZIP 80907
Phone: (719) 475-9023
Get Directions

DR. Justin Tullis, D.D.S is a periodontics dentist in Colorado Springs, CO. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Justin Tullis, D.D.S NPI is 1497115752. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

320 E FONTANERO ST STE 307
COLORADO SPRINGS, CO
ZIP 80907-526
Phone: (719) 475-9023
Fax: (719) 475-9009

The NPI 1497115752 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/1/2016 and was last updated on 1/19/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program			MISSOURI	No
2	1223P0300X	Dentist	Periodontics	204256	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	204256	OTHER	COLORADO	DENTAL LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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