Active NPI
Gregory C. Brandt, DDS, PC
- General Practice Dentistry
- Ankeny, IA
National Provider Identifier
1063557643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6962
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 514194 | Medicaid | IA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Ankeny, IA
- NPI 1033137344
-
- General Practice Dentistry
- Ankeny, IA
- NPI 1912042508
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.