Individual provider Active NPI

Bruce Scott Heinrich, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Redlands, CA
National Provider Identifier
1669556445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DE 032464 Issued in CA
Practice address
219 Cajon St
Redlands, CA 92373-5201
Phone
(909) 793-2603
Fax
(909) 793-6886
NPI assigned
Oct 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DE 032464 CA Primary

Addresses

Primary practice location

219 Cajon St
Redlands, CA 92373-5201

Mailing address

219 Cajon St
Redlands, CA 92373-5201
Phone (909) 793-2603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 1, 2023 through Aug 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DE 032464CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669556445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 CAJON ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735201",
            "telephone_number": "909-793-2603",
            "fax_number": "909-793-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 CAJON ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735201",
            "telephone_number": "909-793-2603",
            "fax_number": "909-793-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINRICH",
        "first_name": "BRUCE",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DE 032464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.