Active NPI
Amy Marie Brandon, D.D.S.
- Pediatric Dentistry
- Concord, CA
National Provider Identifier
1306002225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 52586
- Practice address
- 1255 Willow Pass Rd
Concord, CA 94520-5218 - Phone
- (925) 680-1500
- Fax
- (925) 798-1828
- NPI assigned
- Jul 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 52586 | CA | Primary |
Addresses
Primary practice location
1255 Willow Pass Rd
Concord, CA 94520-5218
Mailing address
1255 Willow Pass Rd
Concord, CA 94520-5218
Phone (925) 680-1500
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150806010290 | CA | Order and Referring Only - Dentist | 1153635966 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1306002225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 WILLOW PASS RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945205218",
"telephone_number": "925-680-1500",
"fax_number": "925-798-1828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 WILLOW PASS RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945205218",
"telephone_number": "925-680-1500",
"fax_number": "925-798-1828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDON",
"first_name": "AMY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-30",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "52586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.