David Lee Brassell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

012226 Issued in GA

Practice address

1383 Manchester Dr NE
Suite a
Conyers, GA 30012-3882

Phone

(770) 922-6149

Fax

(770) 922-6680

NPI assigned

Dec 5, 2006

Sex

Male

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

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1154489490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 MANCHESTER DR NE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123882",
            "telephone_number": "770-922-6149",
            "fax_number": "770-922-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 MANCHESTER DR NE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123882",
            "telephone_number": "770-922-6149",
            "fax_number": "770-922-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSELL",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Conyers, GA
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.