Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Tanner Brunnworth, DMD

Individual provider Dentist · NPI 1508422197

Mr. Tanner Brunnworth, DMD is a Dentist in Crestview, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2019
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

101 4th Ave Ste D
Crestview, FL 32539-2401
Phone: (850) 683-3544
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN24128 (FL)

Record details

NPI number1508422197
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedMay 19, 2019
Last updated in NPPESAugust 6, 2023
Certification dateAugust 6, 2023

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