Organization Active NPI

Richard a. Brazon DDS

  • Dentist
  • Scranton, PA
National Provider Identifier
1053590547
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS021659L Issued in PA
Legal business name
RICHARD A. BRAZON DDS
Practice address
2611 Pittston Ave
Scranton, PA 18505-3217
Phone
(570) 347-2046
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Dr. Richard Alan Brazon, DDSNPI 1548367055
Title
Owner
Phone
(570) 347-2046

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: 193200000X MULTI-SPECIALTY GROUP 122300000X DS021659L PA Primary

Addresses

Primary practice location

2611 Pittston Ave
Scranton, PA 18505-3217

Mailing address

2611 Pittston Ave
Scranton, PA 18505-3217
Phone (570) 347-2046

Other identifiers 1

IdentifierTypeStateIssuer
0014987280001MedicaidPA

National Provider Directory

National Provider Directory

Locations

2611 Pittston Ave
Scranton, PA 18505
Phone (570) 346-2046

Practitioners & affiliated clinicians

Practitioners 4

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": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1053590547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 PITTSTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185053217",
            "telephone_number": "570-347-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 PITTSTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185053217",
            "telephone_number": "570-347-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD A. BRAZON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "BRAZON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-347-2046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS021659L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014987280001",
            "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 Oct 31, 2007; 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.