Individual provider Active NPI

Brian E. Nilges, D.D.S.

  • General Practice Dentistry
  • Redding, CA
National Provider Identifier
1174734982
Registry record updated Jan 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48973 Issued in CA
Practice address
2400 Washington Ave Ste 310
Redding, CA 96001-2814
Phone
(530) 243-3224
Fax
(530) 243-8821
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 48973 CA Primary

Addresses

Primary practice location

2400 Washington Ave Ste 310
Redding, CA 96001-2814

Mailing address

2400 Washington Ave Ste 310
Redding, CA 96001-2814
Phone (530) 243-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150717002786 CA Order and Referring Only - DentistPractitioner - Dentist 5496068595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
48973CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199145600000",
    "number": "1174734982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WASHINGTON AVE STE 310",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012814",
            "telephone_number": "530-243-3224",
            "fax_number": "530-343-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 WASHINGTON AVE STE 310",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012814",
            "telephone_number": "530-243-3224",
            "fax_number": "530-243-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILGES",
        "first_name": "BRIAN",
        "middle_name": "E.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2008-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.