Individual provider Active NPI

Terry L. Bryant, DMD

  • General Practice Dentistry
  • Manchester, KY
National Provider Identifier
1871658229
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6235 Issued in KY
Practice address
1 Fayette Properties Rd
Suite 1B
Manchester, KY 40962-7301
Phone
(606) 599-8856
Fax
(606) 599-8856
NPI assigned
Dec 26, 2006
Last updated
Mar 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6235 KY Primary

Addresses

Primary practice location

1 Fayette Properties Rd
Suite 1B
Manchester, KY 40962-7301

Mailing address

1 Fayette Properties Rd
Suite 1B
Manchester, KY 40962-7301
Phone (606) 599-8856

Other identifiers 1

IdentifierTypeStateIssuer
60062353MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6235KYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1871658229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FAYETTE PROPERTIES RD",
            "address_2": "SUITE 1B",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409627301",
            "telephone_number": "606-599-8856",
            "fax_number": "606-599-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FAYETTE PROPERTIES RD",
            "address_2": "SUITE 1B",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409627301",
            "telephone_number": "606-599-8856",
            "fax_number": "606-599-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TERRY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60062353",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.