BRAD BRYAN, DMD, PA (NPI# 1366636748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366636748 |
| Entity Type | Organization |
| Organization Name | BRAD BRYAN, DMD, PA |
| Other Organization Name | SUNNYBROOK DENTISTRY |
| Practice Address |
2000 S University Ave Little Rock AR 72204 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 7709169000 |
| Mailing Telephone | 7709165028 |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2019-01-04 |
| Authorized Official Name | DR. DALE MAYFIELD (PRESIDENT) |
| Authorized Official Telephone | 7709165036 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| KOOL SMILES | Doing Business As Name - Organization |
| Sunnybrook Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700078029 | Brad Bryan, Dmd, Pa | Dentist | 5111 Rogers Ave, Fort Smith, AR 72903 | 2007-08-10 |
| Street Address |
2000 S UNIVERSITY AVE |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689794703 | Wilber Timothy Norton | Optometrist | 2000 S University Ave, Ste E, Little Rock, AR 72204-3603 | 2007-03-30 |
| 1588206098 | Alice Elizabeth Mccormick | Dentist | 2000 S University Ave, Little Rock, AR 72204-3600 | 2019-10-16 |
| 1215463187 | Sushma Doppalapudi | Dentist | 2000 S University Ave, Little Rock, AR 72204-3600 | 2017-05-11 |
| 1528443140 | Sajini Chandran | Dentist | 2000 S University Ave, Little Rock, AR 72204-3600 | 2015-07-24 |
| 1194085605 | Contact Lenses for Less Inc | Optometrist | 2000 S University Ave, Suite E, Little Rock, AR 72204-3600 | 2012-05-18 |
| 1679711444 | Alissa Medina | Dentist | 2000 S University Ave, Little Rock, AR 72204-3600 | 2009-01-31 |
| 1336390848 | Monica N. Williams | Dentist | 2000 S University Ave, Little Rock, AR 72204-3600 | 2008-10-02 |
| 1114117702 | Aundra Lamond Murphy | Dentist | 2000 S University Ave, Suite K, Little Rock, AR 72204-3600 | 2007-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| Find all providers in zip 72204 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332728 | Michael Drake | Dentist | 9601 Baptist Health Dr Ste 104, Little Rock, AR 72205-6323 | 2020-06-29 |
| 1821567389 | Cantrell Dental | Dentist | 14923 Cantrell Rd, Little Rock, AR 72223-4255 | 2018-11-14 |
| 1992291918 | Darryl K Ragland Dds Pa | Dentist | 11414 W Markham St Ste A, Little Rock, AR 72211-2847 | 2018-07-02 |
| 1114479136 | Arkansas Dental Professionals, Mongrain, P.a | Dentist | 5500 W Markham St, Little Rock, AR 72205-3412 | 2016-10-25 |
| 1467801233 | Joshua Ludford | Dentist | 13600 David O Dodd Rd, Little Rock, AR 72210-2746 | 2016-06-12 |
| 1316392012 | George E Gillian Dds | Dentist | 9700 W Markham St, Little Rock, AR 72205-2124 | 2016-04-30 |
| 1154789121 | Michael L Pohlkamp Dds Pa | Dentist | 16115 Saint Vincent Way Ste 110, Little Rock, AR 72223-3001 | 2016-02-05 |
| 1952772584 | Bethel Burris Oliver Pllc | Dentist | 401 S Bowman Rd, Little Rock, AR 72211-3452 | 2015-10-08 |
| 1184011611 | Richard C Keech, Dds P.a. | Dentist | 7206 F St, Little Rock, AR 72205-2621 | 2015-04-22 |
| 1841690633 | Cantrell West Dental | Dentist | 14309 Cantrell Rd Ste 6, Little Rock, AR 72223-4230 | 2014-08-28 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
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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.