Individual provider Active NPI

William Andrew Brunton, D.M.D

  • Dentist
  • Covington, GA
National Provider Identifier
1205381985
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN015237 Issued in GA
Practice address
4139 Baker St NE Ste 15
Covington, GA 30014-1409
Phone
(770) 787-1013
NPI assigned
Aug 23, 2016
Last updated
Jan 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN015237 GA Primary

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

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN015237GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Covington Dental Care PastSince Jan 19, 2025 Accepting new patients
Conyers Dental Associates, LLC Dentist PastSince Aug 1, 2023 Accepting new patients
Covington Dental Care PastSince Jan 19, 2025 Accepting new patients
Thomas W. Moorman, D.D.S., P.C. PastSince Aug 1, 2023 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1205381985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5173 PAUL CIR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944801",
            "telephone_number": "770-356-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 BAKER ST NE STE 15",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141409",
            "telephone_number": "770-787-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNTON",
        "first_name": "WILLIAM",
        "middle_name": "ANDREW",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-23",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2025; 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.