Individual provider Active NPI

Eric Terrance Braunlin, D.D.S.

  • General Practice Dentistry
  • Cleburne, TX
National Provider Identifier
1265727267
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27028 Issued in TX
Practice address
403 S Colonial Dr
Cleburne, TX 76033-4618
Phone
(817) 645-2486
Fax
(817) 641-2426
NPI assigned
Jun 17, 2011
Last updated
Jan 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27028 TX Primary

Addresses

Primary practice location

403 S Colonial Dr
Cleburne, TX 76033-4618

Mailing address

403 S Colonial Dr
Cleburne, TX 76033-4618
Phone (817) 645-2486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160523001915 TX Order and Referring Only - DentistPractitioner - Dentist 9739478298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27028TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Braunlin and Glover Family Dentistry Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1265727267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 S COLONIAL DR",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334618",
            "telephone_number": "817-645-2486",
            "fax_number": "817-641-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S COLONIAL DR",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334618",
            "telephone_number": "817-645-2486",
            "fax_number": "817-641-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNLIN",
        "first_name": "ERIC",
        "middle_name": "TERRANCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.