Individual provider Active NPI

Gabel C Brizzee, D.D.S.

  • General Practice Dentistry
  • Saint Anthony, ID
National Provider Identifier
1043366982
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3688 Issued in ID
Practice address
305 E 5TH N
Saint Anthony, ID 83445-1626
Phone
(208) 624-3757
NPI assigned
Jan 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-3688 ID Primary

Addresses

Primary practice location

305 E 5TH N
Saint Anthony, ID 83445-1626

Mailing address

PO Box 567
Saint Anthony, ID 83445-0567
Phone (208) 624-3757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20150622000815 ID Order and Referring Only - DentistPractitioner - Dentist 2264743996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-3688IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Toenjes Brizzee & Orme PA General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043366982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 567",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834450567",
            "telephone_number": "208-624-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 5TH N",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834451626",
            "telephone_number": "208-624-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIZZEE",
        "first_name": "GABEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Anthony, ID

Sources for this page

Verify at the official NPI Registry.