Randolph Charles Bryson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9218 Issued in SC

Practice address

1350 Grove Park Dr
Orangeburg, SC 29115-2455

Phone

(803) 387-0682

NPI assigned

Jan 17, 2009

Last updated

Nov 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Las Vegas Beautiful Smiles

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1639310451
  NPD (past)
• Pharar Foundation

  • Dental Clinic/Center
  • Las Vegas, NV
  • NPI 1497465629
  NPD (past)

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

{
    "created_epoch": "1232150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1043457799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WICKLOW DR",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299107329",
            "telephone_number": "215-813-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 GROVE PARK DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291152455",
            "telephone_number": "803-387-0682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1781 Village Center Cir",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891340572",
            "country_code": "US",
            "telephone_number": "702-445-7075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "RANDOLPH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-17",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4977",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephenie Brown, RN, CDE
• Whitney Brown, PHARM. D.
• Chris Brunson, MD
• James H Brunson Jr., MD
• Ashley Meador Bryan, PA
• Zachary Michael Buchanan, DO
• Jerrold M Buckaloo, MD
• Carey Alan Bunch, CPO
• Jennifer S Bunch, OTR/L
• L Jarrette Burckhalter IV, DMD

• General Practice Dentistry in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.

Verify at the official NPI Registry.