Brooke Kondo Rains, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57409 Issued in CA

Practice address

390 S. Green Valley Rd.
#2
Watsonville, CA 95076

Phone

(831) 728-1322

Fax

(831) 728-2778

NPI assigned

Oct 1, 2008

Last updated

Apr 20, 2016By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 28, 2016 through Mar 28, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1053562629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 S. GREEN VALLEY RD.",
            "address_2": "#2",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "95076",
            "telephone_number": "831-728-1322",
            "fax_number": "831-728-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S. GREEN VALLEY RD.",
            "address_2": "#2",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "95076",
            "telephone_number": "831-728-1322",
            "fax_number": "831-728-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINS",
        "first_name": "BROOKE",
        "middle_name": "KONDO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Watsonville, CA
• Providers in Watsonville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.