Mit Brahmbhatt, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN015161 Issued in GA

Practice address

635 Dacula Rd Ste 105
Dacula, GA 30019-2136

Phone

(678) 407-2757

Fax

(678) 367-3728

NPI assigned

Nov 11, 2016

Last updated

Nov 11, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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 GA

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": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1023550753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 DACULA RD STE 105",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192136",
            "telephone_number": "678-407-2757",
            "fax_number": "678-367-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 DACULA RD STE 105",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192136",
            "telephone_number": "678-407-2757",
            "fax_number": "678-367-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHMBHATT",
        "first_name": "MIT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-11",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Dacula, GA
• Providers in Dacula, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; 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.