Bradley William Stutler, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010504A Issued in IN

Practice address

1460 N Green St
Suite 300
Brownsburg, IN 46112-8117

Phone

(317) 852-6620

Fax

(317) 852-6680

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1841230638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N GREEN ST",
            "address_2": "SUITE 300",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461128117",
            "telephone_number": "317-852-6620",
            "fax_number": "317-852-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N GREEN ST",
            "address_2": "SUITE 300",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461128117",
            "telephone_number": "317-852-6620",
            "fax_number": "317-852-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTLER",
        "first_name": "BRADLEY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "1841230638",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010504A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200437880",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Stultz, RBT
• Savanna Stumpo, RBT
• Hilary Leigh Sturm, PA
• William J Sturtevant, PHD
• Stutler Dental Care
• James Francis Sullivan, LSW
• Courtney K Summitt, PT, DPT
• Sunrise Rehab Center LLC
• Superior Healthcare Solutions LLC
• Hayley Surface, OTR

• General Practice Dentistry in Brownsburg, IN
• Providers in Brownsburg, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.