Bryce Earl Potter, MD, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

MD12020 Issued in OR

Practice address

1849 NW Kearney St
Ste 300
Portland, OR 97209-1453

Phone

(503) 224-1371

Fax

(503) 224-0722

NPI assigned

Jul 20, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1346249281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 NW KEARNEY ST",
            "address_2": "STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091453",
            "telephone_number": "503-224-1371",
            "fax_number": "503-224-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 NW KEARNEY ST",
            "address_2": "STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091453",
            "telephone_number": "503-224-1371",
            "fax_number": "503-224-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "BRYCE",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "MD12020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160366",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Satya Potluri, MD
• Afton Power Potter, PNP
• Amanda D Potter
• Angela Potter, N.D.
• Brittany Potter
• Cidnee Potter, IBCLC
• Courteney Potter, QMHP
• Emily Rose Potter
• Kristin Cassidy Potter, MD
• Madeleine Rose Potter, PMHNP-BC

• Oral & Maxillofacial Surgery (D.M.D.) in Portland, OR
• Providers in Portland, OR by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.