Individual provider Active NPI

David J. Brunner, DDS

  • General Practice Dentistry
  • Mequon, WI
National Provider Identifier
1902893209
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5000881 Issued in WI
Practice address
10345 N Port Washington Rd
Suite 100
Mequon, WI 53092-5762
Phone
(262) 240-1200
NPI assigned
Oct 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 5000881 WI Primary

Addresses

Primary practice location

10345 N Port Washington Rd
Suite 100
Mequon, WI 53092-5762

Mailing address

10345 N Port Washington Rd
Suite 100
Mequon, WI 53092-5762
Phone (262) 240-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160217000393 WI Order and Referring Only - DentistPractitioner - Dentist 4486959251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5000881WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1128211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902893209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10345 N PORT WASHINGTON RD",
            "address_2": "SUITE 100",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925762",
            "telephone_number": "262-240-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10345 N PORT WASHINGTON RD",
            "address_2": "SUITE 100",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925762",
            "telephone_number": "262-240-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5000881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.