Active NPI
Bruce Alan Abbott, DDS, PHARMD
- Dentist
- Jbsa Lackland, TX
National Provider Identifier
1790073609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN27904
- Practice address
- 1615 Truemper St
Jbsa Lackland, TX 78236-5511 - Phone
- (210) 292-8980
- NPI assigned
- Jul 12, 2011
- Last updated
- Sep 26, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN27904 | FL | Primary |
| Pharmacist | 183500000X | 1111111111 | TN |
Addresses
Primary practice location
1615 Truemper St
Jbsa Lackland, TX 78236-5511
Mailing address
Wilford Hall Amb Surg Center Jbsa Lackland, Ab, TX
Jbsa Lackland, TX 78259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN27904 | FL | MD | Dentist |
| 1111111111 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758844800000",
"number": "1790073609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WILFORD HALL AMB SURG CENTER JBSA LACKLAND, AB, TX",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "78259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 TRUEMPER ST",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365511",
"telephone_number": "210-292-8980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABBOTT",
"first_name": "BRUCE",
"middle_name": "ALAN",
"credential": "DDS, PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-12",
"last_updated": "2025-09-26",
"certification_date": "2025-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN27904",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "1111111111",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.