Evelyn Marie Bryan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2508 Issued in NH

Practice address

765 So Main St
Suite 202
Manchester, NH 03102

Phone

(603) 622-0279

Fax

(603) 622-3542

NPI assigned

Mar 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Evelyn M Bryan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 30, 2016 through Mar 30, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Evelyn M Bryan DMD PC

  • General Practice Dentistry
  • Manchester, NH
  • NPI 1144424169
  NPD (past) Authorized official

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720110901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 SOUTH MAIN STREET",
            "address_2": "SUITE 202",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03102",
            "telephone_number": "603-622-0279",
            "fax_number": "603-622-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 SO MAIN ST",
            "address_2": "SUITE 202",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03102",
            "telephone_number": "603-622-0279",
            "fax_number": "603-622-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "EVELYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "2508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "BRYAN",
            "middle_name": "M",
            "credential": "DMD PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Demeria M Bruce
• Robin Bruck, D.C.
• Marilyn Anne Bruderer, APRN
• Alexis Jenna Brunelle, PT, DPT
• Mary Brunette, MD
• Hannibal Bryan
• John A Bryan, MD
• Roland R Bryan, DMD
• Ann-Elise Bryant
• Camira Reshea' Bryant, BCBA, LBA

• Dentist in Manchester, NH
• Providers in Manchester, NH by specialty
• Dentist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.