Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRYCE E SLACK
Deactivated Sole ProprietorDR. BRYCE E SLACK is a General Dentistry healthcare provider located in GLENDALE, Arizona. NPI 1013438100 is deactivated in the NPPES registry. Verify at CMS.
General Dentistry · GLENDALE, AZ
This NPI has been deactivated.
The record was deactivated on April 17, 2023.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1013438100
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 29, 2017 (5.8 yrs)
- Last Updated
- Feb 20, 2025
- Deactivated
- Apr 17, 2023
- Licenses
-
6979 (OK)D010940 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5400 W NORTHERN AVE STE 202GLENDALE, AZ, 853011591Browse AZ providers · Browse ZIP 85301
- Phone
- 6235005793
- Fax
- 6233211030
- Primary Specialty
-
General Dentistry
1223G0001X
- Additional Specialty
- General Dentistry
Other General Dentistry Providers in GLENDALE, AZ
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT LEO CRITCHFIELD | DDS | 1447257068 |
| DR. KATHLEEN LYNNE CROWLEY | D.D.S. | 1124025622 |
| DR. ERIC VAN SLUYTERS | DDS | 1578556825 |
| DR. ROBERT C BINGHAM | DDS | 1629063672 |
| JACK JAEKOO HUH | — | 1861483349 |
| DR. CHRISTINE R KIELB | D.M.D | 1750366142 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.