Bryce Dunathan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002109 Issued in WI

Practice address

450 N Koeller St
Oshkosh, WI 54902-4111

Phone

(920) 235-5503

NPI assigned

Jun 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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.

• Oakpark Dental

  • General Practice Dentistry
  • Oshkosh, WI
  • NPI 1386715662
  NPD (past)

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1629639604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024111",
            "telephone_number": "920-235-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNATHAN",
        "first_name": "BRYCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dudley Family Dental LLC
• Ronald Lee Dudley, D.D.S.
• Stephen Sherman Dudley, M.D.
• Meg Duffield
• Michael A Duffy, MD
• Karen Louise Dustrude, DDS
• Eric C Duwell, MD
• Troy Eckes, B.S.W.
• Mindy Eckstein
• Eden Rehabilitation Suites and Green House Homes, Inc.

• General Practice Dentistry in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.