Scott Wayne Hirsbrunner, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

00203761 Issued in CO

Practice address

3952 N Academy Blvd
Colorado Springs, CO 80917-5923

Phone

(719) 591-1811

Fax

(719) 591-2032

NPI assigned

Aug 28, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• White Diamond Dental

  • Dental Clinic/Center
  • Monument, CO
  • NPI 1891663357
  NPD Authorized official
• Austinbluffs Dental Prof. LLC

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1427360254
  NPD (past)
• Sedona Dentistry

  • General Practice Dentistry
  • Sedona, AZ
  • NPI 1194240929
  NPD (past)

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1154848455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175923",
            "telephone_number": "719-591-1811",
            "fax_number": "719-591-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3952 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175923",
            "telephone_number": "719-591-1811",
            "fax_number": "719-591-2032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1785 W Highway 89A Ste 3G",
            "address_purpose": "LOCATION",
            "city": "Sedona",
            "state": "AZ",
            "postal_code": "863365577",
            "country_code": "US",
            "telephone_number": "928-282-9414",
            "fax_number": "928-282-9260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIRSBRUNNER",
        "first_name": "SCOTT",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-28",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009859",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00203761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000173303",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christin Hinzman, DC
• Jennifer Lynn Hipp, PA-C
• Shana Leigh Hirchert, MD
• Mackenzie Hirn, BCBA
• Jesse Sutton Hironymous, DC
• Janet Lynn Hise Finan, MSW
• Dennis Hiser
• Louise E Hisey, NP
• Emilina Raquel Hishmeh, M.D.
• Michael Kragh Hitt, DPT

• Dentist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.