Matthew A. Brunson, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D008212 Issued in AZ

Practice address

Sells Hospital
Hwy 86
Sells, AZ 85634-8563

Phone

(928) 226-7494

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: matthew.brunson.p1@direct.kp-hc.nextgenshare.com

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.

• The Fort Defiance Indian Hospital Board, Incorporation

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment
• Flagstaff Modern Dentistry

  • Dentist
  • Flagstaff, AZ
  • NPI 1386033629
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1770526451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 E ELIDA ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857163221",
            "telephone_number": "734-730-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SELLS HOSPITAL",
            "address_2": "HWY 86",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "856348563",
            "telephone_number": "928-226-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "MATTHEW",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D008212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871683",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• America Rayan Bad Heart Bull, NP
• Deborah Bass, RN BSN
• Moses Benaiah Benavides, M.D.
• Bradley M Bishop, PHARM.D.
• Jocelyn Brown
• Charles Britt Burt, RN
• Claire Patricia Callaway, CPHT
• Mary Anne Carroll
• Paul Matthew Castle
• Jose Cedillo

• All providers in Sells, AZ
• Endodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.