Bryan Rader Dryden, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3332 Issued in ID

Practice address

2344 N Merritt Creek Loop
Coeur D Alene, ID 83814-4950

Phone

(208) 676-8500

Fax

(208) 246-2400

NPI assigned

Aug 18, 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

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Riverstone Dental Care

  • Dentist
  • Coeur D Alene, ID
  • NPI 1619197118
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1487768545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 N MERRITT CREEK LOOP",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144950",
            "telephone_number": "208-676-8500",
            "fax_number": "208-246-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2344 N MERRITT CREEK LOOP",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144950",
            "telephone_number": "208-676-8500",
            "fax_number": "208-246-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYDEN",
        "first_name": "BRYAN",
        "middle_name": "RADER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "3332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "6B836",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dragonfly Support Services, LLC.
• Casey Deanne Drake, MSW
• Tarin Drapeau
• Bradley C Drury, M.D.
• Sydney Drury
• Shannon Dryer, D.D.S.
• Jeremy Jay Duanne, ARNP
• Eryn Ducote
• Edward Charles Dudding, NCC, LPC
• Mary Sandra Duff, ARNP

• All providers in Coeur D Alene, ID
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.