Kenneth L Brunson, DDS.,MS.,

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS1826 Issued in TN

Practice address

212 E Court St
Dyersburg, TN 38024-4742

Phone

(731) 285-9657

Fax

(731) 285-0055

NPI assigned

Nov 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenneth L. Brunson, DDS, Ms, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dyersburg, TN
  • NPI 1912170341
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356410039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E COURT ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380244742",
            "telephone_number": "731-285-9657",
            "fax_number": "731-285-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E COURT ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380244742",
            "telephone_number": "731-285-9657",
            "fax_number": "731-285-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "KENNETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS.,MS.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS1826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL PROVIDER",
            "identifier": "0018158",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audra Boyd, RN
• Sandra D Braddy, TN PEER SPECIALIST
• April Joy Bragg, B.S.
• Chasidy Branch
• Brett Brasfield, PHARM.D.
• Marie Buck
• Addison Burchfiel, DPT
• Kelley C Burg, FNP
• Tina Darlene Burton, LPN
• Forrest K Busch Jr., DO

• Orthodontics and Dentofacial Orthopedics Dentistry in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• 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.