Active NPI
Gary L Bryant, DDS
- General Practice Dentistry
- Wagoner, OK
National Provider Identifier
1285630236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4016
- Practice address
- 104 N Prairie Ave
Wagoner, OK 74467-4320 - Phone
- (918) 485-4559
- Fax
- (918) 485-4550
- NPI assigned
- Jun 23, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4016 | OK | Primary |
Addresses
Primary practice location
104 N Prairie Ave
Wagoner, OK 74467-4320
Mailing address
PO Box 448
Wagoner, OK 74477-0448
Phone (918) 485-4559
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285630236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 448",
"city": "WAGONER",
"state": "OK",
"postal_code": "744770448",
"telephone_number": "918-485-4559",
"fax_number": "918-485-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 N PRAIRIE AVE",
"city": "WAGONER",
"state": "OK",
"postal_code": "744674320",
"telephone_number": "918-485-4559",
"fax_number": "918-485-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "4016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wagoner, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.