Bruce Donald Fisher, M.D., D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

GI-0001121 Issued in DE

Practice address

17605 Nassau Commons Blvd Ste C
Lewes, DE 19958-6284

Phone

(302) 644-2977

Fax

(302) 645-7561

NPI assigned

Jan 31, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern de Oral and Maxillofacial Surgery Associates, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Lewes, DE
  • NPI 1629144589
  NPD Authorized official

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1679610695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17605 NASSAU COMMONS BLVD STE C",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199586284",
            "telephone_number": "302-644-2977",
            "fax_number": "302-645-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17605 NASSAU COMMONS BLVD STE C",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199586284",
            "telephone_number": "302-644-2977",
            "fax_number": "302-645-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "BRUCE",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D., D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "GI-0001121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000014391",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Ann Firuta, PT
• Elizabeth Daedrie Fischer, NP
• William Franklin Fishbein, PH.D.
• Leslie Fishel
• Barbara Fisher, RN
• Linda Fisher
• Lisa Marie Fisher, RN
• Jessica Marie Fitch, RN
• Jennifer Leigh Fitzcharles, RN
• Jacquelyn Kate Fitzgerald, LMT

• Oral and Maxillofacial Surgery (Dentist) in Lewes, DE
• Providers in Lewes, DE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.