Brandon Gervasi

Primary specialty

DentistTaxonomy code 122300000X

License

30.026773 Issued in OH

Practice address

45 E Liberty St
Hubbard, OH 44425-2160

Phone

(330) 534-5408

NPI assigned

Apr 2, 2021

Last updated

Jun 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Braydich Dental Inc

  • General Practice Dentistry
  • Hubbard, OH
  • NPI 1184044604
  NPD (past)

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1215516737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E LIBERTY ST",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444252160",
            "telephone_number": "330-534-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 E LIBERTY ST",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444252160",
            "telephone_number": "330-534-5408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 624",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERVASI",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Yannucci DPM Inc
• Franklin Health Care, Inc
• Shawn Curtis George, BSW
• Shayen A. George, M.A.,
• Robert J. Gerdes
• Janice Marie Gherardi
• Mary Ellen Giglio, LPN
• Karen Giorgetti, PH.D.
• Julia Grady
• Haley N Grimwood, RDN, LDN

• Dentist in Hubbard, OH
• Providers in Hubbard, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.