Paul W Bryan, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5783 Issued in WA

Practice address

2903 E Main
Puyallup, WA 98372-3169

Phone

(253) 845-9507

Fax

(253) 845-5751

NPI assigned

Jun 8, 2006

Last updated

Mar 7, 2023By 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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chet Jenkins PC

  dba Northwest Dental Medicine

  • General Practice Dentistry
  • Puyallup, WA
  • NPI 1548106925
  NPD (past)
• Rochelle J Riley Ddsms PLLC

  • Dentist
  • Puyallup, WA
  • NPI 1679028682
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1831139427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723169",
            "telephone_number": "253-845-9507",
            "fax_number": "253-845-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723169",
            "telephone_number": "253-845-9507",
            "fax_number": "253-845-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "5783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS PROVIDER NUMBER",
            "identifier": "5059001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA & TRICAR",
            "identifier": "717917",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DENTAL SERVICE",
            "identifier": "7192",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "93062",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terese Brunoff
• Brus & Lim, PPLC
• Jeffrey J Brus, DMD
• Michael B Brush, M.D.
• Jessica Danielle Bryan
• Dawna J Bryant
• Dianna Bryant
• Bryce Wilson, PLLC (Northwest Counsel)
• Adam G Buchanan, MD
• Kristina Buchmiller

• General Practice Dentistry in Puyallup, WA
• Providers in Puyallup, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.