Charles M Brenner, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

030573 Issued in NY

Practice address

1875 Hudson Ave
Rochester, NY 14617-5107

Phone

(585) 266-9220

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brenner, Levy, Musiker & Weiner, LLP

  dba North Coast Dental Group

  • General Practice Dentistry
  • Rochester, NY
  • NPI 1922142579

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174667794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 HUDSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175107",
            "telephone_number": "585-266-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 HUDSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175107",
            "telephone_number": "585-266-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "030573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00457410",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "70249",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Mary Brennan, N.P.
• Kristy Lynn Brennan
• Michael Ledwith Brennan, FNP
• Sarah Dawn Brennan
• Amanda Elise Brennen, PA
• Joan Sirelle Brenner, CNM
• Brenner, Levy, Musiker & Weiner, LLP (North Coast Dental Group)
• John V. Brennick
• Christine N. Brent, LCSW-R
• Nicole Brescia, RPA-C

• Pediatric Dentistry in Rochester, NY
• Providers in Rochester, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.