Active NPI
Brian P Edwards, D.M.D.
- Endodontics
- Craig, CO
National Provider Identifier
1265692354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 8174
- Practice address
- 485 Yampa Ave
Craig, CO 81625-2609 - Phone
- (970) 824-8000
- NPI assigned
- Jun 11, 2008
- Last updated
- Jun 11, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 8174 | CO | Primary |
Addresses
Primary practice location
485 Yampa Ave
Craig, CO 81625-2609
Mailing address
485 Yampa Ave
Craig, CO 81625-2609
Phone (970) 824-8000
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 |
|---|---|---|---|
| 8174 | CO | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1265692354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 YAMPA AVE",
"city": "CRAIG",
"state": "CO",
"postal_code": "816252609",
"telephone_number": "970-824-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "485 YAMPA AVE",
"city": "CRAIG",
"state": "CO",
"postal_code": "816252609",
"telephone_number": "970-824-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "BRIAN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CO",
"license": "8174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Craig, CO
- Amber Douglas
- Jennifer Lynn Dunnell, MSOT
- Eastern Rio Blanco County Health Service District (Colorado Advanced Orthopedics Clinic)
- Eastern Rio Blanco County Health Service District (Colorado Advanced Orthopedics Physical Therapy)
- Craig T. Eckroth, O.D.
- Elevated Technologies LLC
- Lynae R Ellgen, LCSW
- Jimmy Scott Ellis, D.O.
- Jona M Ely, NP
- Laurie Engelhardt, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.