Bradley William Renehan, M.D.DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8508 Issued in CO

Practice address

640 Southpointe CT
#150
Colorado Springs, CO 80906-3856

Phone

(719) 540-6350

Fax

(719) 527-9487

NPI assigned

Aug 12, 2005

Last updated

Mar 21, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colorado Surgical Clinic, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Colorado Springs, CO
  • NPI 1598936163
  Authorized official Same address or phone
• Cheyenne Mountain Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Colorado Springs, CO
  • NPI 1518561364
  NPD
• Rocky Mountain Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Littleton, CO
  • NPI 1063534642
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1255333720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 SOUTHPOINTE CT",
            "address_2": "#150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063856",
            "telephone_number": "719-540-6350",
            "fax_number": "719-527-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 SOUTHPOINTE CT",
            "address_2": "#150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063856",
            "telephone_number": "719-540-6350",
            "fax_number": "719-527-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENEHAN",
        "first_name": "BRADLEY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "8508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29054842",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Remus, RBT
• Brittanee Renaker
• Nicole Helen Renaud, DPT
• Regan Danielle Renaud
• Reagan Renda
• Julie Renehan
• Renewed Life Counseling
• Roberta M Renfro, LPC
• Drew Willliam Renfroe, AA
• Yakitta Renfroe, LPC

• Oral and Maxillofacial Surgery (Dentist) in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.