NPIMap

Organization Active NPI

Bryan Dental Group PLLC

  • General Practice Dentistry
  • Bryan, TX
National Provider Identifier
1851147367
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BRYAN DENTAL GROUP PLLC
Practice address
1710 Briarcrest Dr Ste 111
Bryan, TX 77802-2871
Phone
(979) 704-6408
NPI assigned
Apr 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Dr. Brian S Black, DDSNPI 1891015996
Title
Dentist/Owner
Phone
(979) 695-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1710 Briarcrest Dr Ste 111
Bryan, TX 77802-2871

Mailing address

1710 Briarcrest Dr Ste 111
Bryan, TX 77802-2871
Phone (979) 704-6408

National Provider Directory

National Provider Directory

Locations

1710 Briarcrest Dr
Ste 111
Bryan, TX 77802
Phone (979) 704-6408

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1851147367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 BRIARCREST DR STE 111",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022871",
            "telephone_number": "979-704-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 BRIARCREST DR STE 111",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022871",
            "telephone_number": "979-704-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "979-695-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.