Active NPI
Radiant Flux PLLC
- Dentist
- Virginia Beach, VA
National Provider Identifier
1053171462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- RADIANT FLUX PLLC
- Practice address
- 700 Independence Cir Ste 3B
Virginia Beach, VA 23455-6405 - Phone
- (757) 929-7100
- Fax
- (757) 929-7097
- NPI assigned
- Mar 21, 2024
- Organization subpart
- Yes
- Parent organization
- RADIANT FLUX PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Gene Briesemeister, DDS
- Title
- Owner
- Phone
- (757) 929-7100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary | ||
| Customized Equipment (DME) | 332BC3200X |
Addresses
Primary practice location
700 Independence Cir Ste 3B
Virginia Beach, VA 23455-6405
Mailing address
1301 Bridgeport Way Suite 109
Suffolk, VA 23435
Phone (757) 484-1444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250508000123 | VA | DME Supplier - Oral Surgery - Dentist | 6709263478 | Practice locations: Virginia Beach, VA |
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Part of
- Radiant Flux PLLC
Locations
700 Independence Cir
Ste 3B
Virginia Beach, VA 23455
Phone (757) 929-7100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710979200000",
"number": "1053171462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 BRIDGEPORT WAY SUITE 109",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "23435",
"telephone_number": "757-484-1444",
"fax_number": "757-484-3712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 INDEPENDENCE CIR STE 3B",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234556405",
"telephone_number": "757-929-7100",
"fax_number": "757-929-7097"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RADIANT FLUX PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "RADIANT FLUX PLLC",
"enumeration_date": "2024-03-21",
"last_updated": "2024-03-21",
"certification_date": "2021-06-10",
"status": "A",
"authorized_official_last_name": "BRIESEMEISTER",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "GENE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "757-929-7100",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": true
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.