Individual provider Active NPI

Patrick Briscoe, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Longview, TX
National Provider Identifier
1063533354
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
23699 Issued in TX
Practice address
3006 H G Mosley Pkwy
Longview, TX 75605-2948
Phone
(903) 753-2151
Fax
(903) 753-0884
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 23699 TX Primary

Addresses

Primary practice location

3006 H G Mosley Pkwy
Longview, TX 75605-2948

Mailing address

3006 H G Mosley Pkwy
Longview, TX 75605-2948
Phone (903) 753-2151

Other identifiers 2

IdentifierTypeStateIssuer
1114234556OtherTXULTRA ORTHODONTICS
1427168541OtherTXSHERMAN & BRISCOE ORTHODONTICS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
23699TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Orthodontics Orthodontics and Dentofacial Orthopedics CurrentSince Aug 16, 2020 Accepting new patients
Sherman Sherman & Briscoe Orthodontics Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

3006 H G Mosley Pkwy
Longview, TX 75605
Phone (903) 753-2151

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1063533354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 H G MOSLEY PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052948",
            "telephone_number": "903-753-2151",
            "fax_number": "903-753-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 H G MOSLEY PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052948",
            "telephone_number": "903-753-2151",
            "fax_number": "903-753-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCOE",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "23699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ULTRA ORTHODONTICS",
            "identifier": "1114234556",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHERMAN & BRISCOE ORTHODONTICS",
            "identifier": "1427168541",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.