Brantley Blake Dunaway, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4444-24 Issued in MS

Practice address

102 W Freedom Dr
Liberty, MS 39645-7295

Phone

(601) 657-4326

Fax

(601) 657-8867

NPI assigned

Jun 10, 2024

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1093557167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396450511",
            "telephone_number": "601-657-4326",
            "fax_number": "601-657-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W FREEDOM DR",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396457295",
            "telephone_number": "601-657-4326",
            "fax_number": "601-657-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNAWAY",
        "first_name": "BRANTLEY",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "4444-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care One Health
• Care One Health LLC
• Lee Daniel Casey, D.M.D.
• CLC of Liberty, LLC (Liberty Community Living Center)
• Kelli Dawson, FNP-C
• Rebecca R Emfinger, RDN,LD
• Field Memorial Community Hospital (FMCH Liberty Clinic)
• Brittany Forman, CCC-SLP
• Frank B Freeman, DMD
• Chloe Harvey Gill

• General Practice Dentistry in Liberty, MS
• Providers in Liberty, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.