Candace Lauren Bruno, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0025624 Issued in TX

Practice address

11410 Jollyville Rd
3102
Austin, TX 78759-4097

Phone

(512) 372-8484

NPI assigned

Jul 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

State licenses

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1609188259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7416 TURNBUOY DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787304333",
            "telephone_number": "619-261-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 JOLLYVILLE RD",
            "address_2": "3102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594097",
            "telephone_number": "512-372-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "CANDACE",
        "middle_name": "LAUREN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "0025624",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0025624",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2128852-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miguel Angel Bruni Montero
• Madeleine Brunk, LCSW
• Carrie Brunken
• Kirsten A Brunner, MA, LPC
• Jill M Bruno-Enright, MSW
• Jeffery Royce Brunson, DDS
• Camilla Bright Brusenhan
• Brush 32 Dental of Belterra, PLLC
• Brush Dental Domain PC
• Brush Dental Domain PC

• Dentist in Austin, TX
• Providers in Austin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.