Bryce Fenton, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11105993-9922 Issued in UT

Practice address

2441 21St St
USA Dental Activity
Fort Campbell, KY 42223-5582

Phone

(270) 798-8614

NPI assigned

Aug 19, 2014

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

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1154720852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W. 1250 N. SUITE 200",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-753-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "address_2": "USA DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "270-798-8614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 W. 1250 N.",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "UT",
            "postal_code": "84341",
            "country_code": "US",
            "telephone_number": "435-753-7563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTON",
        "first_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202283",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11105993-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fast Response Portable Imaging Inc
• Lindsey Kyle Faudree, PAC
• Shelia Bumpus Faulkner
• Aimee Michelle Feary, PA-C
• Alyson M Fellner
• Blaire M Ferguson, CRNA
• Ian L Ferguson, MD
• Shane Ferrell
• Judy D Fichter
• Christopher Field, PA-C

• General Practice Dentistry in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.