Elizabeth Jane Brachowicz, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN1856052 Issued in MA

Practice address

1036 Brighton Ave
Portland, ME 04102-1059

Phone

(617) 855-5363

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1306194147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021059",
            "telephone_number": "617-855-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021059",
            "telephone_number": "617-855-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACHOWICZ",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas E. Bowman
• Cindy Boyack, MD
• William Chase Boyd, M.D.
• Sarah Tyler Boyne, NP
• Taylor Boynton, LCSW
• Garry G Bracken, D.C.
• Rurik Samual Brackett
• Rita L Bradbury, PT
• Oliver Gilchrist Bradeen, LCPC
• Kathleen R Bradley, PA-C

• All providers in Portland, ME
• Dentist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.

Verify at the official NPI Registry.