Healthcare Provider Details

I. General information

NPI: 1164032090
Provider Name (Legal Business Name): BRETT TAYLOR LYMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 E 30TH AVE STE G
HUTCHINSON KS
67502-8452
US

IV. Provider business mailing address

517 E 30TH AVE STE G
HUTCHINSON KS
67502-8452
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-9136
  • Fax:
Mailing address:
  • Phone: 620-663-9136
  • Fax: 866-453-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number61691
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number61691
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: