James J Bryan, DMD
Individual provider Active NPI General Practice Dentistry · Latrobe, PA
NPI 1730219460 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1730219460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS025044L (PA)
- Practice address
- 215 Depot St
Latrobe, PA 15650-1802 - Phone
- (724) 537-6640
- Fax
- (724) 537-7588
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160226000186 | PA | Order and Referring Only - Other (Physician) |
2163727371 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS025044L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inner Strength Counseling | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS025044L | PA | Yes |
Addresses
Primary practice location
215 Depot St
Latrobe, PA 15650-1802
Mailing address
215 Depot St
Latrobe, PA 15650-1802
Phone (724) 537-6640
Other providers in Latrobe, PA
- Rachel Jiangying Bridge
- Bridget B. Nair O.D.
- Michael John Brownfield
- Bruce a Hershock MD LTD
- Joyce M Brun
- Thomas A Buches
- Katherine Mary Bumbernick
- Rebecca Ann Burd
- Joseph C Bures
- Rachel Burkardt
All providers in Latrobe, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.