Active NPI
Bryce Stewart Putnam, DMD
- Dentist
- Elko, NV
National Provider Identifier
1205126414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6134
- Practice address
- 762 14TH St
Elko, NV 89801-3413 - Phone
- (775) 772-0343
- NPI assigned
- Apr 10, 2011
- Last updated
- Sep 26, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6134 | NV | Primary |
Addresses
Primary practice location
762 14TH St
Elko, NV 89801-3413
Mailing address
762 14TH St
Elko, NV 89801-3413
Phone (775) 772-0343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160118000815 | NV | Order and Referring Only - Dentist | 6800199365 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6134 | NV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nevada Health Centers Inc | Past | Accepting new patients |
Interoperability endpoints
- bputnam695092@direct.ochin.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Elko Family Medical and Dental Center
- Federally Qualified Health Center (FQHC)
- Elko, NV
- NPI 1073690616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1205126414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "762 14TH ST",
"city": "ELKO",
"state": "NV",
"postal_code": "898013413",
"telephone_number": "775-772-0343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "762 14TH ST",
"city": "ELKO",
"state": "NV",
"postal_code": "898013413",
"telephone_number": "775-772-0343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTNAM",
"first_name": "BRYCE",
"middle_name": "STEWART",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-10",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "6134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elko, NV
- Premise Health of Nevada Medical Hinitt PC (Golden Health Family Medical Center)
- Jeffrey L. Price, CADC, LCSW
- Stephen Calvert Price, D.D.S.
- Primary Choice Health and Wellness PLLC (Primary Choice Health and Wellness)
- Vanessa Rene Pruessing
- Ester M Quilici, LADC
- Chad E Quintero, M.D.
- Rebecca Anne Rader
- Rain Down Blessings Inc
- Jordan J Ramirez, LCSW-10619-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.