Individual provider Active NPI

Bruce Howard Dentler, MD, ABFP, CMD

  • Geriatric Medicine (Family Medicine) Physician
  • Spokane, WA
National Provider Identifier
1124116611
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD00014194 Issued in WA
Practice address
1010 W Rosewood Ave
Spokane, WA 99208-4257
Phone
(509) 465-9776
Fax
(509) 465-9058
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD00014194 WA Primary

Addresses

Primary practice location

1010 W Rosewood Ave
Spokane, WA 99208-4257

Mailing address

1010 W. Rosewood Ave.
Geriatric Family Care
Spokane, WA 99208-4257
Phone (509) 465-9776

Other identifiers 1

IdentifierTypeStateIssuer
1073923MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Family Care, PS Geriatric Medicine PastSince May 25, 2007 Accepting new patients
Inpatient Consultants of California, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1124116611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W. ROSEWOOD AVE.",
            "address_2": "GERIATRIC FAMILY CARE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084257",
            "telephone_number": "509-465-9776",
            "fax_number": "509-465-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W ROSEWOOD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084257",
            "telephone_number": "509-465-9776",
            "fax_number": "509-465-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTLER",
        "first_name": "BRUCE",
        "middle_name": "HOWARD",
        "credential": "MD, ABFP, CMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00014194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073923",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.