Bryan Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BRYAN MODERN DENTISTRY, PC

Practice address

3001 Wildflower Dr
Suite511
Bryan, TX 77802-3061

Phone

(979) 776-1040

Fax

(979) 776-1048

NPI assigned

Oct 2, 2014

Organization subpart

No

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

Authorized official

Name

Dr. John S Barnes, DDS

Title

Owner

Phone

(979) 776-1040

Specialties & licenses 1

Addresses

Other names 1

• Bryan Modern Dentistry Doing business as

Locations

Practitioners 3

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

• Alicia Diane Ates, DDS

  • General Practice Dentistry
  • Bryan, TX
  • NPI 1942789110
  NPD (past)
• Adam Safari, DDS

  • Dentist
  • Bryan, TX
  • NPI 1578292116
  NPD (past)
• Golden Ofoh

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
  • NPI 1295477313

  General Practice

  NPD (past)

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1568865798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WILDFLOWER DR",
            "address_2": "SUITE511",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023061",
            "telephone_number": "979-776-1040",
            "fax_number": "979-776-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-776-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryan Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bryan Gastropath, LLC
• Bryan Isd
• Bryan Kidney Center PLLC
• Bryan Medical Associates Medical Association
• Bryan Medical Center, LLC
• Bryan Opco LLC
• Bryan Pediatric Dentistry
• Bryan Radiology Associates
• Bryan Radiology Associates
• Bryan SNF, LLC

• General Practice Dentistry in Bryan, TX
• Providers in Bryan, 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 Oct 2, 2014; 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.