Individual provider Active NPI

Brian W Courtney, D.M.D.

  • Dentist
  • Hartford, CT
National Provider Identifier
1194806083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4216 Issued in CT
Practice address
One Gold St.
Hartford, CT 06103
Phone
(860) 728-5264
Fax
(860) 527-0932
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4216 CT Primary

Addresses

Primary practice location

One Gold St.
Hartford, CT 06103

Mailing address

One Gold St.
Hartford, CT 06103
Phone (860) 728-5264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160502000229 CT Order and Referring Only - DentistPractitioner - Dentist 5991004657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194806083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GOLD ST.",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06103",
            "telephone_number": "860-728-5264",
            "fax_number": "860-527-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GOLD ST.",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06103",
            "telephone_number": "860-728-5264",
            "fax_number": "860-527-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTNEY",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "4216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.