Active NPI
Susan Bradley Dunn, DDS
- Dentist
- Syracuse, NY
National Provider Identifier
1972624914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 045257
- Practice address
- 1304 Buckley Rd
Suite 203
Syracuse, NY 13212-4311 - Phone
- (315) 474-1711
- Fax
- (315) 474-4818
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 045257 | NY | Primary |
Addresses
Primary practice location
1304 Buckley Rd
Suite 203
Syracuse, NY 13212-4311
Mailing address
1304 Buckley Rd
Suite 203
Syracuse, NY 13212-4311
Phone (315) 474-1711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045257 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1972624914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 BUCKLEY RD",
"address_2": "SUITE 203",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132124311",
"telephone_number": "315-474-1711",
"fax_number": "315-474-4818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 BUCKLEY RD",
"address_2": "SUITE 203",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132124311",
"telephone_number": "315-474-1711",
"fax_number": "315-474-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "SUSAN",
"middle_name": "BRADLEY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "045257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.