Beth Brunner, DMD, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

054553 Issued in NY

Legal business name

BETH BRUNNER, DMD, PLLC

Practice address

1936 Saranac Ave
Suite 101
Lake Placid, NY 12946-1114

Phone

(518) 837-5019

Fax

(518) 837-5093

NPI assigned

Oct 27, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Beth Brunner, DMD, MD, PLLCNPI 1649432139

Title

Owner

Phone

(518) 837-5019

Specialties & licenses 1

Addresses

Other names 1

• Lake Placid Oral Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beth Brunner, DMD, MD, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Placid, NY
  • NPI 1649432139
  NPD (past) Authorized official

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1487930004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 SARANAC AVE",
            "address_2": "SUITE 101",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461114",
            "telephone_number": "518-837-5019",
            "fax_number": "518-837-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 SARANAC AVE",
            "address_2": "SUITE 101",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461114",
            "telephone_number": "518-837-5019",
            "fax_number": "518-837-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH BRUNNER, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "BRUNNER",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-837-5019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD, PLLC"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "054553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Placid Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stuart John Baird IV
• Carol Baker
• Alexander Baldwin
• David J Balestrini, D.M.D.
• Elizabeth Bartos, M.D.
• Molly Breen, OTR/L
• Beth Brunner, DMD, MD, PLLC
• Daniel P Bullock, MD
• Eugene Byrne, MD
• Capital District Optimal Health Inc

• All providers in Lake Placid, NY
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.