Provider Demographics
NPI:1235150913
Name:BRUMIT, STEPHEN WAYNE (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:WAYNE
Last Name:BRUMIT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 SW 3RD ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-2258
Mailing Address - Country:US
Mailing Address - Phone:816-554-0022
Mailing Address - Fax:816-554-0052
Practice Address - Street 1:519 SW 3RD ST
Practice Address - Street 2:SUITE E
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2258
Practice Address - Country:US
Practice Address - Phone:816-554-0022
Practice Address - Fax:816-554-0052
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO145291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics