Glen Louis Bruenjes, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10801 Issued in TX

Practice address

909 Dairy Ashford St
104
Houston, TX 77079-5309

Phone

(281) 493-4173

Fax

(281) 493-4388

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Locations

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.

• Glen L Bruenjes DDS PLLC

  • Durable Medical Equipment & Medical Supplies
  • Houston, TX
  • NPI 1619534567
  NPD Authorized official
• Evan C. Adams DDS PLLC

  • Dental Clinic/Center
  • Houston, TX
  • NPI 1851944011
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1528150653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 DAIRY ASHFORD RD STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795306",
            "telephone_number": "281-493-4173",
            "fax_number": "281-493-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 DAIRY ASHFORD ST",
            "address_2": "104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795309",
            "telephone_number": "281-493-4173",
            "fax_number": "281-493-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUENJES",
        "first_name": "GLEN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "10801",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "10801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara L. Bruce, M. D.
• Dawn Michelle Bruder, LPC
• Brueggen Dental Implant Center
• Harold Wayne Brueggen, DDS
• Brian Mendoza Bruel, M.D., M.B.A
• Eduardo D. Bruera, M.D.
• Sebastian Bruera
• Patricia Ann Bruha, RN, BSN, WHNP-BC
• Kindell Bruington, LPC
• Peter Russell Brumback, CRNA

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.