Individual provider Active NPI

Brian Tory Heine, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Paducah, KY
National Provider Identifier
1083787386
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6942 Issued in KY
Practice address
2850 Lone Oak Rd Ste #6
Paducah, KY 42003-8043
Phone
(270) 554-2026
Fax
(270) 554-2028
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 6942 KY
Dentist 122300000X 6942 KY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6942 KY Primary

Addresses

Primary practice location

2850 Lone Oak Rd Ste #6
Paducah, KY 42003-8043

Mailing address

2850 Lone Oak Rd Ste #6
Paducah, KY 42003-8043
Phone (270) 554-2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2017 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heine, Heine and Bowles, PLLC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1083787386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 LONE OAK RD STE #6",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420038043",
            "telephone_number": "270-554-2026",
            "fax_number": "270-554-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 LONE OAK RD STE #6",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420038043",
            "telephone_number": "270-554-2026",
            "fax_number": "270-554-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINE",
        "first_name": "BRIAN",
        "middle_name": "TORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "6942",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6942",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "6942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.