Bryce D. Deter, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-018584 Issued in IL

Practice address

2025 Aberdeen Court
Sycamore, IL 60178

Phone

(815) 758-3666

Fax

(815) 758-3626

NPI assigned

Apr 26, 2007

Sex

Male

Sole proprietor

Yes

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)

Not 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.

• Collins Dental Group, P.C.

  • General Practice Dentistry
  • Sycamore, IL
  • NPI 1215157797
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1104046689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 ABERDEEN COURT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-758-3666",
            "fax_number": "815-758-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 ABERDEEN COURT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-758-3666",
            "fax_number": "815-758-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETER",
        "first_name": "BRYCE",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8079",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-018584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dekalb Surgical Services, LLC
• Geraldine Maniago Delos Santos, D.O.
• Thomas Dennison, M.D.
• Dental Professionals of Illinois, P.C.
• Millicent Derro, DPT
• Susanne Dewey
• Dialysis of Northern Illinois LLC
• Dialysis of Northern Illinois LLC
• Emily Anne Dienst
• Ashley Nicole Divine, APRN

• General Practice Dentistry in Sycamore, IL
• Providers in Sycamore, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.