Individual provider Active NPI

David Franklin Brust, D.D.S.

  • General Practice Dentistry
  • Northfield, MN
National Provider Identifier
1295895803
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11116 Issued in MN
Practice address
2011 Jefferson Rd.
Northfield, MN 55057
Phone
(507) 645-9543
Fax
(507) 645-5612
NPI assigned
Dec 12, 2006
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
General Practice Dentistry 1223G0001X 11116 MN Primary

Addresses

Primary practice location

2011 Jefferson Rd.
Northfield, MN 55057

Mailing address

2011 Jefferson Rd.
Northfield, MN 55057
Phone (507) 645-9543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160408001499 MN Order and Referring Only - General PracticePractitioner - General Practice 5890093793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Dental Care LTD General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295895803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 JEFFERSON RD.",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "55057",
            "telephone_number": "507-645-9543",
            "fax_number": "507-645-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 JEFFERSON RD.",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "55057",
            "telephone_number": "507-645-9543",
            "fax_number": "507-645-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUST",
        "first_name": "DAVID",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, MN

Sources for this page

Verify at the official NPI Registry.