MR. SHAE DANIEL BRYANT (NPI# 1063039501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063039501 |
| Entity Type | Individual |
| Full Name | MR. SHAE DANIEL BRYANT |
| Credential | DDS |
| Practice Address |
101 Bodin Cir Travis Afb CA 94535-1809 |
| Mailing Address |
694 A St Travis Afb CA 94535-2301 |
| Practice Telephone | 7074237000 |
| Mailing Telephone | 7024237241 |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 11826424-9921 | UT | Dental Providers |
| Street Address |
101 BODIN CIR |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893276 | Charles A Tujo | Radiology | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-06-30 |
| 1538769351 | Chelsey Violet Pelkey | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-30 |
| 1538768114 | Jordan Rose | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-23 |
| 1821606591 | Madelyn Hale | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-20 |
| 1932727856 | Julie Thein | Audiologist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-07 |
| 1598381089 | Aaron J Surbaugh | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-06-19 |
| 1194348466 | Amanda Vance | Registered Nurse | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-05-21 |
| 1427681196 | Bradley Burkey | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-20 |
| 1821629288 | Gloria Calvillo | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-03 |
| 1649810458 | Andrew Lawrence Pierson | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881934016 | Sarah Michelle Ringdahl | Dentist | 60mdg/sgdd, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2013-02-25 |
| 1598965824 | Kongkiat Ratanatharathorn | Dentist | 60 Mdg Sdgg, 101 Bodin Cir, Travis Afb, CA 94535 | 2007-07-24 |
| 1487738605 | Thasanai Roongruangphol | Dentist | 349 Amds, Travis Afb, CA 94535 | 2006-10-24 |
| 1811900434 | Hong Van Baker | Dentist | 60mdg 101 Bodin Circle, Travis Afb, Ca 94535-1800, 60mdg 101 Bodin Circle, Travis Afb, Ca 94535-1800, Travis Afb, CA 94535-1800 | 2006-08-14 |
| 1568445039 | Javier A Abreu | Dentist | 151 Bodin Cir Bldg 775, Travis Afb, CA 94535-1801 | 2005-11-29 |
| 1962494559 | Martin J Hamilton | Dentist | 151 Bodin Cir, Travis Afb, CA 94535-1801 | 2005-08-19 |
| 1881696458 | Corey Mark Stanley | Dentist | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535 | 2005-08-12 |
| 1033670351 | Daniel Kim | Dentist | 151 Bodin Cir Bldg 775, Travis Afb, CA 94535-1801 | 2019-03-28 |
| 1235625047 | John Smith | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2018-07-04 |
| 1417453077 | Shane Russell William Pascoe | Dentist | 101 Bodin Cir, Travis Afb, CA 94535 | 2018-04-03 |
| Find all providers in TRAVIS AFB | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.