Bryan Scott Eder, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV2957 Issued in WV

Practice address

71 Maccorkle Ave SW
South Charleston, WV 25303

Phone

(304) 744-8448

Fax

(304) 744-4344

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275625964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25303",
            "telephone_number": "304-744-8448",
            "fax_number": "304-744-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25303",
            "telephone_number": "304-744-8448",
            "fax_number": "304-744-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDER",
        "first_name": "BRYAN",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV2957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132821000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shay Eagle
• Deborah L Eastman
• Hannah Eck
• Kristen Eddy
• Donny Edens
• Charlotte Gwynne Edmonds
• Grace Edmunds, PA-C
• Kate Edokpolor Ayanru
• Donna Edwards
• Harriette Edwards

• General Practice Dentistry in South Charleston, WV
• Providers in South Charleston, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.