Jerald S. Pruner, DMD, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

JERALD S. PRUNER, DMD, PLLC

Practice address

1221 Madison St Ste 1116
Seattle, WA 98104-3536

Phone

(206) 215-2088

NPI assigned

Feb 6, 2025

Organization subpart

No

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

Authorized official

Name

Jerald Scott Pruner, DMDNPI 1134234313

Title

Owner/ President

Phone

(206) 215-2088

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerald S Pruner, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
  • NPI 1134234313
  NPD Authorized official
• Gary R Feldman, DDS MD PS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Seattle, WA
  • NPI 1245330059
  NPD
• Dale S Bloomquist, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
  • NPI 1740348705
  NPD (past)

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1821802000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 MADISON ST STE 1116",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043536",
            "telephone_number": "206-215-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MADISON ST STE 1116",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043536",
            "telephone_number": "206-215-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERALD S. PRUNER, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "PRUNER",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "206-215-2088",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyeong Yun Jeong, MD
• Shannon Jeong
• Shigyong Jeong, PHARMD
• Jennie Jepsen
• Jennifer Jepsen, OTD/OTR/L
• Ashley M Jerath Tatum, M.D.
• Greta Jerdo
• Jere & Krishna, PLLC
• Deepali Jere, BDS, MPH, MS
• Joseph Andrew Jereczek, DPT

• Oral and Maxillofacial Surgery Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.