Individual provider Active NPI

Thomas Brindock, DMD

  • Dentist
  • White Oak, PA
National Provider Identifier
1063652055
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS019520L Issued in PA
Practice address
1631 Kansas Avenue
White Oak, PA 15131
Phone
(412) 673-1120
NPI assigned
Mar 3, 2009
Last updated
Jul 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS019520L PA Primary

Addresses

Primary practice location

1631 Kansas Avenue
White Oak, PA 15131

Mailing address

1631 Kansas Avenue
White Oak, PA 15131
Phone (412) 673-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419001817 WV Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3375841786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS019520LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1063652055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 KANSAS AVENUE",
            "city": "WHITE OAK",
            "state": "PA",
            "postal_code": "15131",
            "telephone_number": "412-673-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 KANSAS AVENUE",
            "city": "WHITE OAK",
            "state": "PA",
            "postal_code": "15131",
            "telephone_number": "412-673-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINDOCK",
        "first_name": "THOMAS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-03",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS019520L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Oak, PA

Sources for this page

Verify at the official NPI Registry.