NPIMap

Organization Active NPI

Larry W. Bryant DDS, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Glenn Dale, MD
National Provider Identifier
1194092148
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
07738 Issued in MD
Legal business name
LARRY W. BRYANT DDS, PC
Practice address
12200 Annapolis Rd
Suite 236-240
Glenn Dale, MD 20769-9182
Phone
(301) 249-0553
Fax
(301) 249-0555
NPI assigned
Nov 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Dr. Larry Winfred Bryant, DDSNPI 1902960958
Title
Owner
Phone
(301) 249-0553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 07738 MD Primary

Addresses

Primary practice location

12200 Annapolis Rd
Suite 236-240
Glenn Dale, MD 20769-9182

Mailing address

12200 Annapolis Rd
Suite 236-240
Glenn Dale, MD 20769-9182
Phone (301) 249-0553

Other names 1

  • Larry W. Bryant DDS, PC Former legal business name

National Provider Directory

National Provider Directory

Locations

12200 Annapolis Rd
Ste 236240
Glenn Dale, MD 20769
Phone (301) 249-0553

12200 Annapolis Rd
Ste 236
Glenn Dale, MD 20769
Phone (301) 249-0553

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1194092148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "SUITE 236-240",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-249-0553",
            "fax_number": "301-249-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "SUITE 236-240",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-249-0553",
            "fax_number": "301-249-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY W. BRYANT DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "WINFRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-249-0553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "07738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larry W. Bryant DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.