Active NPI
Kenneth L. Brunson, DDS, Ms, PC
- Orthodontics and Dentofacial Orthopedics Dentistry
- Dyersburg, TN
National Provider Identifier
1912170341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS1826
- Legal business name
- KENNETH L. BRUNSON, DDS, MS, PC
- Practice address
- 1950 US Highway 51 Byp N
Suite a
Dyersburg, TN 38024-1896 - Phone
- (731) 285-9657
- Fax
- (731) 285-0055
- NPI assigned
- Apr 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth L Brunson, DDS, MS
- Title
- Doctor/Owner
- Phone
- (731) 285-9657
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS1826 | TN | Primary |
Addresses
Primary practice location
1950 US Highway 51 Byp N
Suite a
Dyersburg, TN 38024-1896
Mailing address
1950 US Highway 51 Byp N
Suite a
Dyersburg, TN 38024-1896
Phone (731) 285-9657
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18158 | Other | TN | DORAL DENTAL USA |
National Provider Directory
National Provider DirectoryLocations
1950 US Highway 51 Byp N
Ste A
Dyersburg, TN 38024
Phone (731) 285-9657
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Dyersburg, TN
- NPI 1356410039
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1207526400000",
"number": "1912170341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 US HIGHWAY 51 BYP N",
"address_2": "SUITE A",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241896",
"telephone_number": "731-285-9657",
"fax_number": "731-285-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 US HIGHWAY 51 BYP N",
"address_2": "SUITE A",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380241896",
"telephone_number": "731-285-9657",
"fax_number": "731-285-0055"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENNETH L. BRUNSON, DDS, MS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-07",
"last_updated": "2008-04-07",
"status": "A",
"authorized_official_last_name": "BRUNSON",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "DOCTOR/OWNER",
"authorized_official_telephone_number": "731-285-9657",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS, MS"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TN",
"license": "DS1826",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL USA",
"identifier": "18158",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dyersburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.