Henry Gasson Bryan, D.D.S.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

HB014814 Issued in MI

Practice address

20805 E 12 Mile Rd
Suite 110
Roseville, MI 48066-6502

Phone

(586) 778-2100

NPI assigned

Jul 10, 2006

Last updated

Apr 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hbryan1119263@direct.hfhs.org

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

• Renaissance Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Roseville, MI
  • NPI 1235325499
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1992739379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20805 E 12 MILE RD",
            "address_2": "SUITE 110",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480666502",
            "telephone_number": "586-778-2100",
            "fax_number": "586-778-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20805 E 12 MILE RD",
            "address_2": "SUITE 110",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480666502",
            "telephone_number": "586-778-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "HENRY",
        "middle_name": "GASSON",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "HB014814",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "HB014814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2932746",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca L Bremer, DO
• Kelsey Anne Brengman, PA-C
• Robert Brinker, OD
• Lisa Gaye Brooks, LLP
• Bruce G. Johnson, Dopc
• David Peter Bryk, DDS
• Emanuel Buggs
• Brandon Bulmer, NP
• Louise Michelle Burgan, MSW
• Dawn M Burke, CNP

• Oral & Maxillofacial Surgery (D.M.D.) in Roseville, MI
• Providers in Roseville, MI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.