William Andrew Brunton, D.M.D
Individual provider Active NPI Dentist · Covington, GA
NPI 1205381985 · NPPES record last updated Jan 12, 2025
Key facts
- NPI
- 1205381985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN015237 (GA)
- Practice address
- 4139 Baker St NE Ste 15
Covington, GA 30014-1409 - Phone
- (770) 787-1013
- NPI assigned
- Aug 23, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015237 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas W. Moorman, D.D.S., P.C. | Past |
Accepting new patients | |
| Covington Dental Care | Past |
Accepting new patients | |
| Covington Dental Care | Past |
Accepting new patients | |
| Conyers Dental Associates, LLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN015237 | GA | Yes |
Addresses
Primary practice location
4139 Baker St NE Ste 15
Covington, GA 30014-1409
Mailing address
5173 Paul Cir SW
Conyers, GA 30094-4801
Phone (770) 356-2092
Other providers in Covington, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.