Brian Lory Danielsson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35243 Issued in CA

Practice address

700 N Sanders St
Suite a
Ridgecrest, CA 93555-3528

Phone

(760) 371-4800

Fax

(760) 371-4825

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 5, 2016 through Aug 5, 2026

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Brian L Danielsson DDS PC

  dba Ridgecrest Cosmetic Dentistry

  • General Practice Dentistry
  • Ridgecrest, CA
  • NPI 1801535067
  NPD Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184706509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N SANDERS ST",
            "address_2": "SUITE A",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553528",
            "telephone_number": "760-371-4800",
            "fax_number": "760-371-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N SANDERS ST",
            "address_2": "SUITE A",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553528",
            "telephone_number": "760-371-4800",
            "fax_number": "760-371-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSSON",
        "first_name": "BRIAN",
        "middle_name": "LORY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Critical Care Registered Nursing Nurse Anesthesia Inc
• Natasha Sophie Cruz
• Sunit Dalal
• Hoang Anh Dang
• Daniel H. Mallory, O.D.
• Karen Elizabeth Davin, NP
• Shannon Elizabeth Davis
• Sue Marie Davis
• John De Geus, M.D.
• Julie De Jesus

• General Practice Dentistry in Ridgecrest, CA
• Providers in Ridgecrest, 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 Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.