Individual provider Active NPI

Bryan Rector, D.D.S.

  • General Practice Dentistry
  • Muncie, IN
National Provider Identifier
1871887885
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011649A Issued in IN
Practice address
3905 N Wheeling Ave
Muncie, IN 47304-1769
Phone
(765) 286-4017
Fax
(765) 286-0372
NPI assigned
Jun 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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 12011649A IN Primary

Addresses

Primary practice location

3905 N Wheeling Ave
Muncie, IN 47304-1769

Mailing address

3905 N Wheeling Ave
Muncie, IN 47304-1769
Phone (765) 286-4017

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161026000220 IN Order and Referring Only - DentistPractitioner - Dentist 1456639434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey a. Rector, D.D.S., LLC Past Accepting new patients
Family Orthodontics of Indiana, LLC PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1871887885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041769",
            "telephone_number": "765-286-4017",
            "fax_number": "765-286-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041769",
            "telephone_number": "765-286-4017",
            "fax_number": "765-286-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECTOR",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011649A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.