Organization Active NPI

Gregory C. Brandt, DDS, PC

  • General Practice Dentistry
  • Ankeny, IA
National Provider Identifier
1063557643
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6962 Issued in IA
Legal business name
GREGORY C. BRANDT, DDS, PC
Practice address
907 N. Ankeny Blvd.
Ankeny, IA 50023
Phone
(515) 964-1490
Fax
(515) 965-5603
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Dr. Gregory C. Brandt
Title
President
Phone
(515) 964-1490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6962 IA Primary

Addresses

Primary practice location

907 N. Ankeny Blvd.
Ankeny, IA 50023

Mailing address

PO Box 547
Ankeny, IA 50021-0547
Phone (515) 964-1490

Other identifiers 1

IdentifierTypeStateIssuer
514194MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1063557643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500210547",
            "telephone_number": "515-964-1490",
            "fax_number": "515-965-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N. ANKENY BLVD.",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "50023",
            "telephone_number": "515-964-1490",
            "fax_number": "515-965-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY C. BRANDT, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-964-1490",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514194",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

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