Individual provider Active NPI

David Ross Bright, D.D.S.

  • Endodontics
  • Tyler, TX
National Provider Identifier
1639206758
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
10101 Issued in TX
Practice address
4605 Old Bullard Rd
Tyler, TX 75703-1232
Phone
(903) 939-3636
Fax
(903) 939-1687
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 10101 TX Primary

Addresses

Primary practice location

4605 Old Bullard Rd
Tyler, TX 75703-1232

Mailing address

4605 Old Bullard Rd
Tyler, TX 75703-1232
Phone (903) 939-3636

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150721002484 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2860705746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10101TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Endodontics, PLLC Endodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639206758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 OLD BULLARD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031232",
            "telephone_number": "903-939-3636",
            "fax_number": "903-939-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 OLD BULLARD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031232",
            "telephone_number": "903-939-3636",
            "fax_number": "903-939-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHT",
        "first_name": "DAVID",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "10101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.