Shyam Brahmbhatt, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63509 Issued in CA

Practice address

422 Orange St
Redlands, CA 92374-3206

Phone

(909) 792-7500

NPI assigned

Oct 22, 2014

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 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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Jackson Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Redlands, CA
  • NPI 1992899777

  General Practice

  NPD (past)

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1174928915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 ORANGE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743206",
            "telephone_number": "909-792-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 ORANGE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743206",
            "telephone_number": "909-792-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHMBHATT",
        "first_name": "SHYAM",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anneliese Mary Elizabeth Boyle
• Boys & Girls Clubs of Greater Redlands-Riverside
• Bradford Healthcare
• Donald Damon Bradley, MSW
• Rebecca Lee Bradshaw, CMT
• Brand New Pharmacy Inc
• Brand New Pharmacy Inc
• Cherry L. Brandstater, M.D.
• David Brandt, NP
• Jens Peter Brandt, R.P.T

• General Practice Dentistry in Redlands, CA
• Providers in Redlands, CA by specialty
• General Practice Dentistry in California

• 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.
• 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.