Active NPI
Brent J. Callegari, DENTIST
- Orthodontics and Dentofacial Orthopedics Dentistry
- Boerne, TX
National Provider Identifier
1245200591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 16171
- Practice address
- 9627 Boerne SPG
Boerne, TX 78006-9394 - Phone
- (210) 268-9863
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16171 | TX | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 16171 | TX | Primary |
Addresses
Primary practice location
9627 Boerne SPG
Boerne, TX 78006-9394
Mailing address
9627 Boerne SPG
Boerne, TX 78006-9394
Phone (210) 268-9863
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 |
|---|---|---|---|
| 16171 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1245200591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9627 BOERNE SPG",
"city": "BOERNE",
"state": "TX",
"postal_code": "780069394",
"telephone_number": "210-268-9863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9627 BOERNE SPG",
"city": "BOERNE",
"state": "TX",
"postal_code": "780069394",
"telephone_number": "210-268-9863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLEGARI",
"first_name": "BRENT",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "DENTIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "16171",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "16171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.