Individual provider Active NPI

Bryan K Pike, DDS

  • General Practice Dentistry
  • Great Falls, MT
National Provider Identifier
1962529081
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2099 Issued in MT
Practice address
2615 16TH Avenue South
Great Falls, MT 59404
Phone
(406) 727-5343
Fax
(406) 727-9608
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2099 MT Primary

Addresses

Primary practice location

2615 16TH Avenue South
Great Falls, MT 59404

Mailing address

2615 16TH Avenue South
Great Falls, MT 59404
Phone (406) 727-5343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20160201001304 MT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668776386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2099MTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962529081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 16TH AVENUE SOUTH",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59404",
            "telephone_number": "406-727-5343",
            "fax_number": "406-727-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 16TH AVENUE SOUTH",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59404",
            "telephone_number": "406-727-5343",
            "fax_number": "406-727-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "BRYAN",
        "middle_name": "K",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.