Kevin M Brousseau, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17150 Issued in MA

Practice address

152 Emory St
Attleboro, MA 02703-2461

Phone

(508) 222-8838

Fax

(508) 226-8157

NPI assigned

Jul 28, 2010

Sex

Male

Sole proprietor

No

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

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1154635530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 EMORY ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032461",
            "telephone_number": "508-222-8838",
            "fax_number": "508-226-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 EMORY ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032461",
            "telephone_number": "508-222-8838",
            "fax_number": "508-226-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSEAU",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annika Bridges
• Elizabeth Broderick
• Adam Brodeur
• Brousseau & Brousseau PC
• Justin Michael Brousseau
• Patricia L Brousseau, RN
• Alexia Brown
• Brittanie Marie Brown
• Keona Cierra Brown
• Latisha Brown

• General Practice Dentistry in Attleboro, MA
• Providers in Attleboro, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.