Breanna Bartolome, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106878 Issued in CA

Practice address

15 Sierra Gate PLZ
Roseville, CA 95678-6602

Phone

(916) 786-6777

NPI assigned

Aug 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Arena Gade Wilkes Milla McClure Dental Corporation

  • Dentist
  • Roseville, CA
  • NPI 1730117300
  NPD (past)

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1093481749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SIERRA GATE PLZ",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786602",
            "telephone_number": "916-786-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SIERRA GATE PLZ",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786602",
            "telephone_number": "916-786-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLOME",
        "first_name": "BREANNA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Barriga Mendoza
• Aamanzhane Dashay Barron
• Monique L Barroso
• Molly Barry
• Michelle Bartley
• Mackenzie Joseph Barton, DO
• Jan Williams Bartuska
• Rhonda E Basarich, D.C.
• Claire Basco
• Leopoldo Mario Basilico, M.D.

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.