Healthcare Provider Details

I. General information

NPI: 1487641171
Provider Name (Legal Business Name): AMY LYNN BRYER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LYNN BRYER BRYER DDS

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 W CHILDS AVE
MERCED CA
95341-6805
US

IV. Provider business mailing address

999 N PACIFIC ST UNIT B313
OCEANSIDE CA
92054-2017
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-4842
  • Fax: 209-383-6624
Mailing address:
  • Phone: 917-710-2316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number57028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: