Individual provider Active NPI

Robert H Brandes, D.D.S.

  • Periodontics
  • Livermore, CA
National Provider Identifier
1114165255
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
34673 Issued in CA
Practice address
1171 Murrieta Blvd
Suite 200
Livermore, CA 94550-4143
Phone
(925) 449-6633
Fax
(925) 449-0766
NPI assigned
Jan 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 34673 CA Primary

Addresses

Primary practice location

1171 Murrieta Blvd
Suite 200
Livermore, CA 94550-4143

Mailing address

1171 Murrieta Blvd
Suite 200
Livermore, CA 94550-4143
Phone (925) 449-6633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34673CAMDPediatric Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shayna Rondon DDS Inc Periodontics PastSince Apr 9, 2019 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": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1114165255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 MURRIETA BLVD",
            "address_2": "SUITE 200",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504143",
            "telephone_number": "925-449-6633",
            "fax_number": "925-449-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 MURRIETA BLVD",
            "address_2": "SUITE 200",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504143",
            "telephone_number": "925-449-6633",
            "fax_number": "925-449-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDES",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "34673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.