Individual provider Active NPI

Frank Paul Brettschneider, DDS

  • Dentist
  • Kimball, MI
National Provider Identifier
1124702535
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601792 Issued in MI
Practice address
2837 Stable Dr Ste a
Kimball, MI 48074-1441
Phone
(810) 985-3301
Fax
(855) 747-1702
NPI assigned
Jun 14, 2023
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901601792 MI Primary

Addresses

Primary practice location

2837 Stable Dr Ste a
Kimball, MI 48074-1441

Mailing address

8454 Lakeshore Rd
Burtchville, MI 48059-1329
Phone (810) 434-0934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230926000430 MI Order and Referring Only - DentistPractitioner - Dentist 8921452954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901601792MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott J. Ferguson DDS & Associates PLLC Dentist PastSince Jun 18, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1124702535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8454 LAKESHORE RD",
            "city": "BURTCHVILLE",
            "state": "MI",
            "postal_code": "480591329",
            "telephone_number": "810-434-0934",
            "fax_number": "855-747-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2837 STABLE DR STE A",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480741441",
            "telephone_number": "810-985-3301",
            "fax_number": "855-747-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETTSCHNEIDER",
        "first_name": "FRANK",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kimball, MI

Sources for this page

Verify at the official NPI Registry.