NPIMap

Organization Active NPI

Dr Michael Brennan D.M.D.

  • Dentist
  • Scranton, PA
National Provider Identifier
1013257930
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS026290-L Issued in PA
Legal business name
DR MICHAEL BRENNAN D.M.D.
Practice address
128 N Main Ave
Scranton, PA 18504-3327
Phone
(570) 344-5511
NPI assigned
Mar 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Michael BrennanNPI 1992715171
Title
Dentist
Phone
(570) 344-5511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DS026290-L PA Primary

Addresses

Primary practice location

128 N Main Ave
Scranton, PA 18504-3327

Mailing address

128 N Main Ave
Scranton, PA 18504-3327
Phone (570) 344-5511

Other identifiers 1

IdentifierTypeStateIssuer
0011290720001OtherPAMEDICAL ASSISTANCE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1013257930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 N MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185043327",
            "telephone_number": "570-344-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185043327",
            "telephone_number": "570-344-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MICHAEL BRENNAN D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "570-344-5511"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS026290-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "0011290720001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.