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Elizabeth Pullockaran

Dentist - General Practice β€’ Poplar Bluff, MO

Active NPI 1356913412 Individual Practitioner Female Practitioner
Practice location in NPPES

1500 N Westwood Blvd
Poplar Bluff, MO 639013318

Call 5736864151 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1500 N Westwood Blvd

Poplar Bluff, MO 639013318

Telephone 5736864151
Organization at the Same NPPES Address or Phone
St. Louis Jc Vamc Facility NPI 1588622880

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Poplar Bluff and Missouri

20 active clinicians are listed under Dentist - General Practice with a practice address in Poplar Bluff, MO (1,988 in Missouri).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Poplar Bluff

0% of these 20 clinicians have the CMS telehealth indicator.

0% of these 20 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-06-01
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES NJ 22DI02843600

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Missouri Board of Registration for the Healing Arts.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

27 listed
Donna Akers , FNP-C

Nurse Practitioner - Family

NPI 1851370340

Family Nurse Practitioner (Certified)

NPI 1174643373

Master of Physical Therapy, Certified Strength and Conditioning Specialist, CEAS

Kimberly Brown , AGNP-BC

Nurse Practitioner - Adult Health

NPI 1861952756

Adult-Gerontology Nurse Practitioner (Board Certified)

Maggie Buckley , MSW, LCSW

Social Worker - Clinical

NPI 1003359563

Master of Social Work, Licensed Clinical Social Worker

NPI 1457809485

Doctor of Optometry

NPI 1518999473

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location June 01, 2025

Registered at 1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 639013318 (Tel: 5736864151)

πŸ“
Updated Business Mailing Address June 01, 2025

Registered at 1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 639013318 (Tel: 5736864151)

βœ…
NPI Profile Active July 16, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 16, 2021

Registered at 957 NJ-33, HAMILTON TOWNSHIP, NJ 08690 (Tel: 6095875858)

πŸ“
Business Mailing Address (Initial Record) July 16, 2021

Registered at 201 BERWYN PL, LAWRENCE TOWNSHIP, NJ 086483607 (Tel: 6098584126)

πŸ‘€
Provider Name / Credentials (Initial Record) July 16, 2021

Recorded as ELIZABETH PULLOCKARAN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 16, 2021

Dentist (license number reported to NPPES: NJ 22DI02843600)

🟒
Initial NPI Registration & Enumeration July 16, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1356913412
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 16, 2021
Last Update: June 01, 2025
Sole Proprietor: No

Other Dentist - General Practices in Poplar Bluff

All Dentist - General Practices in Poplar Bluff

Mailing Address

1500 N Westwood Blvd

Poplar Bluff, MO 639013318

Phone: 5736864151

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.