NPIMap

Organization Active NPI

Bruce S. Wyman DMD, PC

  • Periodontics
  • Springfield, VA
National Provider Identifier
1528272499
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401004973 Issued in VA
Legal business name
BRUCE S. WYMAN DMD, PC
Practice address
6116 Rolling Rd
Suite 312
Springfield, VA 22152-1521
Phone
(703) 569-4040
Fax
(703) 569-7334
NPI assigned
May 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bruce S Wyman, DMDNPI 1063424638
Title
President
Phone
(703) 569-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401004973 VA Primary

Addresses

Primary practice location

6116 Rolling Rd
Suite 312
Springfield, VA 22152-1521

Mailing address

6116 Rolling Rd
Suite 312
Springfield, VA 22152-1521
Phone (703) 569-4040

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528272499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 ROLLING RD",
            "address_2": "SUITE 312",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521521",
            "telephone_number": "703-569-4040",
            "fax_number": "703-569-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 ROLLING RD",
            "address_2": "SUITE 312",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521521",
            "telephone_number": "703-569-4040",
            "fax_number": "703-569-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE S. WYMAN DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-569-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401004973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.