Bruce Schwandt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30695 Issued in CA

Practice address

48 NE 11TH St
Madras, OR 97741-1865

Phone

(629) 999-5014

NPI assigned

Aug 25, 2006

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Nosti and Reagan Dental Corporation

  • General Practice Dentistry
  • San Marcos, CA
  • NPI 1699874925
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1083721831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 NE 11TH ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411865",
            "telephone_number": "629-999-5014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 Center Dr",
            "address_2": "STE. 101",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "CA",
            "postal_code": "920693536",
            "country_code": "US",
            "telephone_number": "760-746-2045",
            "fax_number": "760-746-2033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWANDT",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11072",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Dewitt Savage, M.D.
• Kimberly Anne Schmith, L.AC
• Wayne Thomas Schultz, D.D.S.
• Schultztoms LLC
• Aj Schuster, MD
• Anita Sergeant, TWH
• Ivaniel Serrano
• Kellie Marie Shepherd, CARE GIVER
• Jessica Silva-Olivas
• Karla Rene'E Simmelink, RN

• General Practice Dentistry in Madras, OR
• Providers in Madras, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.