Chase Daniel Bruner, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS10223 Issued in IA

Practice address

18 1St Ave NW
Waukon, IA 52172

Phone

(563) 568-4528

Fax

(563) 568-6144

NPI assigned

Jun 24, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northeast Iowa Dental Professional Corporation

  • General Practice Dentistry
  • Waukon, IA
  • NPI 1720173990
  NPD (past)

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1235973199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 1ST AVE NW",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "52172",
            "telephone_number": "563-568-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 1ST AVE NW",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "52172",
            "telephone_number": "563-568-4528",
            "fax_number": "563-568-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "CHASE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS10223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Anderson, FNP-C
• Alex Mitchell Berns, DNP FNP-C
• Mark P Bishop, CRNA
• Rebecca Booth, DPT
• Steven Breitenfield
• Daphne Machelle Bruner, DDS
• Jacqueline Jo Bucheit, DC
• Nicole Busta
• Tarynne Carlson, MOT
• Linda Sue Carstens, DDS

• Dentist in Waukon, IA
• Providers in Waukon, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.

Verify at the official NPI Registry.