Bryan Russell Katz, DDS – General Practice Dentistry

Key facts

NPI: 1770898751
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 22DIO2424100 (NJ)
Practice address: 90 Vandenberg Dr
66 MDS (Afmc)
Hanscom Afb, MA 01731-2104
Phone: (781) 225-6789
Fax: (781) 225-2564
NPI assigned: Aug 13, 2010
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Corner Dentistry LLP Dental Clinic/Center · Philadelphia, PA · NPI 1447639521

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
22DIO2424100	NJ	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Corner Dentistry LLP		Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	22DIO2424100	NJ	Yes

Addresses

Primary practice location

90 Vandenberg Dr
66 MDS (Afmc)
Hanscom Afb, MA 01731-2104

Mailing address

90 Vandenberg Dr
66 MDS (Afmc)
Hanscom Afb, MA 01731-2104
Phone (781) 225-6789

Other providers in Hanscom Afb, MA

All providers in Hanscom Afb, MA · General Practice Dentistry in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.