Phillip B Bruner, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3573CS Issued in AL

Practice address

400 Saraland Blvd N
Suite a
Saraland, AL 36571-2152

Phone

(251) 675-5861

Fax

(251) 675-5105

NPI assigned

Apr 4, 2007

Last updated

Jul 7, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1598887085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SARALAND BLVD N",
            "address_2": "SUITE A",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712152",
            "telephone_number": "251-675-5861",
            "fax_number": "251-675-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SARALAND BLVD N",
            "address_2": "SUITE A",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712152",
            "telephone_number": "251-675-5861",
            "fax_number": "251-675-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "PHILLIP",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3573CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INSURANC",
            "identifier": "591870",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "510 90863",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Letah Bishop, PHARMD
• Layle Dean Boatwright, O.D.
• Claire Booker, RD, LD
• Steven Ray Booker Jr., L.P.C, N.C.C.
• Cherish Brannon, CAC, MAC
• Bruno's Supermarkets, LLC. (Food World Pharmacy #337)
• George H Burroughs, D.C.
• Jarrod A Cain, D.P.T
• Scott Q Carver
• Ray E Case, DC

• General Practice Dentistry in Saraland, AL
• Providers in Saraland, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.