Organization Active NPI

Kevin M Brunski DDS PC

  • General Practice Dentistry
  • Crown Point, IN
National Provider Identifier
1669554606
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009160 Issued in IN
Legal business name
KEVIN M BRUNSKI DDS PC
Practice address
1410 E Joliet St
Suite D
Crown Point, IN 46307-4724
Phone
(219) 662-9932
Fax
(219) 663-9688
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dorothy J Jacobs
Title
Office Manager
Phone
(219) 662-9932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 12009160 IN Primary

Addresses

Primary practice location

1410 E Joliet St
Suite D
Crown Point, IN 46307-4724

Mailing address

1410 E Joliet St
Suite D
Crown Point, IN 46307-4724
Phone (219) 662-9932

National Provider Directory

National Provider Directory

Locations

1410 E Joliet St
#D
Crown Point, IN 46307
Phone (219) 662-9262

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669554606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E JOLIET ST",
            "address_2": "SUITE D",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074724",
            "telephone_number": "219-662-9932",
            "fax_number": "219-663-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E JOLIET ST",
            "address_2": "SUITE D",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074724",
            "telephone_number": "219-662-9932",
            "fax_number": "219-663-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN M BRUNSKI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "219-662-9932"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.