Active NPI
Brooke Borusiewicz, RDH
- Dental Hygienist
- North Charleston, SC
National Provider Identifier
1205459294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 10412
- Practice address
- 3455 Airframe Dr
North Charleston, SC 29418 - Phone
- (843) 925-9296
- NPI assigned
- May 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 10412 | SC | Primary |
Addresses
Primary practice location
3455 Airframe Dr
North Charleston, SC 29418
Mailing address
219 Fort St
Summerville, SC 29485-8387
Phone (843) 302-2817
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10412 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590364800000",
"number": "1205459294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 FORT ST",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858387",
"telephone_number": "843-302-2817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 AIRFRAME DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "29418",
"telephone_number": "843-925-9296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORUSIEWICZ",
"first_name": "BROOKE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-25",
"last_updated": "2020-05-25",
"certification_date": "2020-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "SC",
"license": "10412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.