Walter Robert Bryant, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN8121 Issued in FL

Practice address

1173 Spring Centre South Blvd
Suite a
Altamonte Springs, FL 32714-1976

Phone

(407) 628-9523

NPI assigned

May 22, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073723003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 SPRING CENTRE SOUTH BLVD",
            "address_2": "SUITE A",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141976",
            "telephone_number": "407-628-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 SPRING CENTRE SOUTH BLVD",
            "address_2": "SUITE A",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141976",
            "telephone_number": "407-628-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "WALTER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN8121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070427000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dieunifere Santhia Brutus
• Agatha Bryan
• Dominique Alicia Bryan, APRN
• Alison Page Bryant, LMHC
• Heather Lin Bryant, ARNP
• Suzanne Kathleen Bryskin, M.D.
• Howard S Buchoff, M.D.
• Jodee Sue Buis, LMHC
• Janet Marie Buitron, CST, CSFA
• Cassandra Bukaty, APRN

• Orthodontics and Dentofacial Orthopedics Dentistry in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.