Individual provider Active NPI

Scott A Bryant, D.D.S.

  • Endodontics
  • Temple, TX
National Provider Identifier
1124368584
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
021.003056 Issued in IL
Practice address
2419 Palermo Pkwy BLDG D
Temple, TX 76502-3790
Phone
(254) 374-6680
NPI assigned
Feb 22, 2013
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 021.003056 IL Primary
Endodontics 1223E0200X 41407 TX

Addresses

Primary practice location

2419 Palermo Pkwy BLDG D
Temple, TX 76502-3790

Mailing address

2419 Palermo Pkwy BLDG D
Temple, TX 76502-3790
Phone (254) 374-6680

Other practice location 1

375 MDG
310 W. Losey Street
Scott AFB, IL 62225
Phone (618) 256-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627001709 IL Order and Referring Only - DentistPractitioner - Dentist 1153700810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021.003056ILMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1124368584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 PALERMO PKWY BLDG D",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023790",
            "telephone_number": "254-374-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 PALERMO PKWY BLDG D",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023790",
            "telephone_number": "254-374-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 MDG",
            "address_2": "310 W. Losey Street",
            "address_purpose": "LOCATION",
            "city": "Scott AFB",
            "state": "IL",
            "postal_code": "62225",
            "country_code": "US",
            "telephone_number": "618-256-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-22",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021.003056",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "41407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.