George W Brazeal, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

26591 Issued in CA

Practice address

2345 E Coast Hwy
Suite B
Corona del Mar, CA 92625-2034

Phone

(949) 673-6443

NPI assigned

Oct 29, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1003807199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E COAST HWY",
            "address_2": "SUITE B",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252034",
            "telephone_number": "949-673-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 E COAST HWY",
            "address_2": "SUITE B",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252034",
            "telephone_number": "949-673-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEAL",
        "first_name": "GEORGE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-29",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shuling Beckstead
• Paul K Berg, MD
• Richard Carl Beuttler, PSY.D.
• Erin Boatwright, RD
• Brett Christopher Brazeal, DDS
• David E Brock, RADT
• Tami Broderick, R.D.
• California Center for Pelvic Floor Disorders Inc
• CDM Dental Corp
• CDM Medical Inc

• Dentist in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.