Brad Young Bryan, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3347-05 Issued in MS

Practice address

4463 N State St
Jackson, MS 39206-5306

Phone

(601) 714-2908

NPI assigned

Aug 17, 2006

Last updated

Mar 31, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1790899912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4463 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065306",
            "telephone_number": "601-946-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4463 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065306",
            "telephone_number": "601-714-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "BRAD",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3347-05",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Angela Brunson, M.S., CCC-SLP
• Lindsey Thompson Brunson
• Otis Hendon Brunson IV, MD
• Neely Grace Brunt
• Valerie Brunt, NP
• Catherine Supple Bryant, PA-C
• Danielle Bolton Bryant
• Geoffrey Bryant, MD
• Gidarell Bryant Jr.
• Jarrod Bryant

• General Practice Dentistry in Jackson, MS
• Providers in Jackson, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.