Kori Suzanne Bryant, DDS

Individual provider Active NPI Pediatric Dentistry · Manhattan, KS

NPI 1194131672 · NPPES record last updated Oct 23, 2020

Key facts

NPI
1194131672
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
61117 (KS)
Practice address
1133 College Avenue
Suite D164
Manhattan, KS 66502-2940
Phone
(785) 776-7242
Fax
(785) 776-7243
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
61117KSMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Apple Pediatric Dentistry, LLC Pediatric Dentistry Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 61117 KS Yes

Addresses

Primary practice location

1133 College Avenue
Suite D164
Manhattan, KS 66502-2940

Mailing address

1133 College Avenue
Suite D164
Manhattan, KS 66502-2940
Phone (785) 776-7242

Other providers in Manhattan, KS

All providers in Manhattan, KS · Pediatric Dentistry in Kansas

Sources for this page

Verify at the official NPI Registry.