Healthcare Provider Details

I. General information

NPI: 1467379040
Provider Name (Legal Business Name): ROBERT PAUL BRYNIARSKI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

IV. Provider business mailing address

14967 E MARATHON DR
FOUNTAIN HILLS AZ
85268-1332
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-5011
  • Fax:
Mailing address:
  • Phone: 480-250-5233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012893
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: