Individual provider Active NPI

James Kenneth Brigham, DDS

  • Dentist
  • Clovis, CA
National Provider Identifier
1295855534
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24216 Issued in CA
Practice address
334 Shaw
Suite 130
Clovis, CA 93612
Phone
(559) 298-7500
Fax
(559) 298-5600
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24216 CA Primary

Addresses

Primary practice location

334 Shaw
Suite 130
Clovis, CA 93612

Mailing address

1797 Portals Ave
Clovis, CA 93611
Phone (559) 299-1945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160513000274 CA Order and Referring Only - DentistPractitioner - Dentist 5698064749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24216CAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295855534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1797 PORTALS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93611",
            "telephone_number": "559-299-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 SHAW",
            "address_2": "SUITE 130",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93612",
            "telephone_number": "559-298-7500",
            "fax_number": "559-298-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHAM",
        "first_name": "JAMES",
        "middle_name": "KENNETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "24216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.