Active NPI
Bryce R Doty, DMD
- Dentist
- Anaheim, CA
National Provider Identifier
1114230281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61359
- Practice address
- 500 S Anaheim Hills Rd Ste 146
Anaheim, CA 92807-4761 - Phone
- (503) 318-2007
- NPI assigned
- Jul 19, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9458 | OR | |
| Dentist | 122300000X | 61359 | CA | Primary |
Addresses
Primary practice location
500 S Anaheim Hills Rd Ste 146
Anaheim, CA 92807-4761
Mailing address
500 S Anaheim Hills Rd Ste 146
Anaheim, CA 92807-4761
Phone (503) 918-2007
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
| License | State | Type | Specialty |
|---|---|---|---|
| D9458 | OR | MD | Dentist |
| 61359 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1114230281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S ANAHEIM HILLS RD STE 146",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074761",
"telephone_number": "503-918-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S ANAHEIM HILLS RD STE 146",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074761",
"telephone_number": "503-318-2007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTY",
"first_name": "BRYCE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-19",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D9458",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.