Active NPI
Lance Q. Bruntz, D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Reno, NV
National Provider Identifier
1154799534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- S3-72
- Practice address
- 3605 Grant Dr
Reno, NV 89509-5301 - Phone
- (775) 825-4804
- NPI assigned
- Sep 2, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | S3-72 | NV | Primary |
Addresses
Primary practice location
3605 Grant Dr
Reno, NV 89509-5301
Mailing address
3605 Grant Dr
Reno, NV 89509-5301
Phone (775) 825-4804
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 |
|---|---|---|---|
| S3-72 | NV | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1154799534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 GRANT DR",
"city": "RENO",
"state": "NV",
"postal_code": "895095301",
"telephone_number": "775-825-4804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 GRANT DR",
"city": "RENO",
"state": "NV",
"postal_code": "895095301",
"telephone_number": "775-825-4804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNTZ",
"first_name": "LANCE",
"middle_name": "Q.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NV",
"license": "S3-72",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.