NPIMap

Organization Active NPI

Eric W. Brust DDS PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Taylor, MI
National Provider Identifier
1174695522
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
15547 Issued in MI
Legal business name
ERIC W. BRUST DDS PC
Practice address
10460 Pelham Rd
Taylor, MI 48180-3828
Phone
(313) 299-9700
Fax
(313) 299-9951
NPI assigned
Nov 14, 2006
Last updated
Oct 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Dr. Eric W Brust, DDS MSNPI 1538385869
Title
Owner
Phone
(313) 299-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 15547 MI Primary

Addresses

Primary practice location

10460 Pelham Rd
Taylor, MI 48180-3828

Mailing address

10460 Pelham Rd
Taylor, MI 48180-3828
Phone (313) 299-9700

Other identifiers 2

IdentifierTypeStateIssuer
193998OtherMIUNITED CONCORDIA
123042560OtherMICSHCS

National Provider Directory

National Provider Directory
Tax ID family
Eric W Brust DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10460 Pelham Rd
Taylor, MI 48180
Phone (313) 299-9700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1174695522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10460 PELHAM RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803828",
            "telephone_number": "313-299-9700",
            "fax_number": "313-299-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10460 PELHAM RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803828",
            "telephone_number": "313-299-9700",
            "fax_number": "313-299-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC W. BRUST DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "BRUST",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-299-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "15547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "193998",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCS",
            "identifier": "123042560",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.