Bryan D Basom, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30.022613 Issued in OH

Practice address

11 Medical Dr
Chillicothe, OH 45601-8603

Phone

(740) 775-8050

Fax

(740) 775-8053

NPI assigned

Oct 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Magnolia Dental

  • General Practice Dentistry
  • Chillicothe, OH
  • NPI 1104134881
  NPD Authorized official

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1043499650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MEDICAL DR",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018603",
            "telephone_number": "740-775-8050",
            "fax_number": "740-775-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MEDICAL DR",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018603",
            "telephone_number": "740-775-8050",
            "fax_number": "740-775-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASOM",
        "first_name": "BRYAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.022613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audra Ann Barron, RN
• Natasha Michelle Barron
• Amy Nicole Barrows, NP-C, FNP-BC
• Chester Park Barton III, MD
• Candace Nicole Bartrum
• Garrett Michael Bassett, D.O.
• Lacey Bateman
• Mary Bauman
• Whitney Sue Bauman, AUD
• Zachary Baumgard

• Dentist in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.