Individual provider Active NPI

Julia Maria Bruno, D.M.D.

  • Dentist
  • Atlanta, GA
National Provider Identifier
1073692430
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DPH00005 Issued in GA
Practice address
99 Jesse Hill Jr. Drive
Atlanta, GA 30303-3030
Phone
(404) 730-1471
Fax
(404) 730-1475
NPI assigned
Nov 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2236 PR
Dentist 122300000X DPH00005 GA Primary

Addresses

Primary practice location

99 Jesse Hill Jr. Drive
Atlanta, GA 30303-3030

Mailing address

99 Jesse Hill Jr. Drive
Atlanta, GA 30303-3030
Phone (404) 730-1471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20171127002420 GA Order and Referring Only - DentistPractitioner - Dentist 3577820737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DPH00005GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1073692430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 JESSE HILL JR. DRIVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033030",
            "telephone_number": "404-730-1471",
            "fax_number": "404-730-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 JESSE HILL JR. DRIVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033030",
            "telephone_number": "404-730-1471",
            "fax_number": "404-730-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "JULIA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-04",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "2236",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DPH00005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.