DR. GEORGE ANTHONY BRUDER III (NPI# 1780868430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780868430 |
| Entity Type | Individual |
| Full Name | DR. GEORGE ANTHONY BRUDER III |
| Credential | D.M.D. |
| Practice Address |
Stony Brook Dental Associates Inc Sullivan Hall - Room 170 - Faculty Practice Stony Brook NY 11794-8705 |
| Practice Telephone | 6316328971 |
| Practice Fax Number | 6316327658 |
| Mailing Telephone | 6316328971 |
| Mailing Fax Number | 6316327658 |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
50 050928 | NY | Dental Providers |
| Street Address |
STONY BROOK DENTAL ASSOCIATES INC SULLIVAN HALL - ROOM 170 - FACULTY PRACTICE |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-8705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184709123 | Jerome Cymerman | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2006-10-26 |
| 1114450327 | Rita Susan O'dwyer | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2017-04-05 |
| 1598029779 | Advanced Endodontics of Long Island, P.C. | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2012-07-02 |
| 1518226265 | Tej Vaidya | Dentist | Stony Brook University Hospital, Medical/house Staff Svc. Dept. 9-110, Stony Brook, NY 11794-0001 | 2012-05-15 |
| 1619110996 | Brian Mccormack | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2009-04-15 |
| 1285882340 | James L Kantor | Dentist | Stony Brook University, Rockland Hall Room 140, Stony Brook, NY 11794-0001 | 2008-09-03 |
| 1629252507 | Shin Chieh Yang | Dentist | Stony Brook University Hospital, Medical House Staff Office, Stony Brook, NY 11794-0001 | 2007-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026235 | Sanghyun Park | Dentist | 1103 Stewart Ave Ste 104, Garden City, NY 11530-4886 | 2020-09-03 |
| 1164031654 | Harp Endodontics PC | Dentist | 121 E 60th St Apt 10a, New York, NY 10022-1198 | 2020-07-30 |
| 1518590918 | All County Endodontics, PC | Dentist | 112 Westminster Rd, Scarsdale, NY 10583-2425 | 2020-02-14 |
| 1245862325 | Marie Milagros Mora Moreno | Dentist | 345 E 24th St Dept Of, New York, NY 10010-4020 | 2020-02-06 |
| 1407406218 | Geoffrey Louis Sas | Dentist | 1414 Avenue of The Americas Fl 19, New York, NY 10019-2514 | 2019-09-13 |
| 1790340875 | Kim & Wang Dds Pllc | Dentist | 10737 71st Ave Ste 203, Forest Hills, NY 11375-4736 | 2019-05-05 |
| 1003373903 | Prohealth Dental Pllc | Dentist | 5011 Vernon Blvd, Long Island City, NY 11101 | 2019-02-27 |
| 1023575982 | Prohealth Dental Pllc | Dentist | 16345 Crossbay Blvd, Howard Beach, NY 11414-3741 | 2019-02-27 |
| 1114494911 | Alf Hitel Bunes | Dentist | 900 Starboard Side Ln Apt 306, Webster, NY 14580-2288 | 2018-10-30 |
| 1972086684 | Steven Kyongmin Kim | Dentist | 209 E 56th St Frnt 1, New York, NY 10022 | 2018-09-09 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
Please comment or provide details below to improve the information on DR. GEORGE ANTHONY BRUDER III.
| 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.