Robert C Bruckner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

5402 Mineral Point Road
Suite 1
Madison, WI 53705-4659

Phone

(608) 231-2863

Fax

(608) 231-2974

NPI assigned

Aug 31, 2006

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

Other names 1

• Dr. Robert C Bruckner Professional name

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407967698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 MINERAL POINT ROAD",
            "address_2": "SUITE 1",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054659",
            "telephone_number": "608-231-2863",
            "fax_number": "608-231-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5402 MINERAL POINT ROAD",
            "address_2": "SUITE 1",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054659",
            "telephone_number": "608-231-2863",
            "fax_number": "608-231-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE TO PRACTICE",
            "identifier": "5001006015",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "BRUCKNER",
            "middle_name": "C",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Ann Bruce
• Justine Yang Bruce
• Richard James Bruce, M.D.
• Elizabeth A Bruckbauer, APRN, BC
• Justin Lee Brucker, M.D.
• Danielle C Bruder, APRN
• Susan Ingrid Brueggemann, PHYSICIAN ASSISTANT
• Tracy Jean Bruggink
• Catherine M Brumm, DDS
• Elsa Bruner

• All providers in Madison, WI
• General Practice Dentistry in Wisconsin

• 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.