Individual provider Active NPI

John West Bryson, DMD

  • Pediatric Dentistry
  • Fort Benning, GA
National Provider Identifier
1083728968
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN009620 Issued in GA
Practice address
7101 Hoff St,BLDG 9240
USA Dental Activity
Fort Benning, GA 31905
Phone
(706) 544-4530
Fax
(706) 544-1933
NPI assigned
Aug 18, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN009620 GA
Pediatric Dentistry 1223P0221X DN009620 GA Primary

Addresses

Primary practice location

7101 Hoff St,BLDG 9240
USA Dental Activity
Fort Benning, GA 31905

Mailing address

4 Trapper CT
Midland, GA 31820-3807
Phone (706) 544-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN009620GAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083728968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 TRAPPER CT",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318203807",
            "telephone_number": "706-544-4530",
            "fax_number": "706-544-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 HOFF ST,BLDG 9240",
            "address_2": "USA DENTAL ACTIVITY",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "706-544-4530",
            "fax_number": "706-544-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "JOHN",
        "middle_name": "WEST",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN009620",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN009620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Benning, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.