Anthony Giacomo Brusca, DDS
Individual provider Active NPI Public Health Dentistry · Globe, AZ
NPI 1326166604 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1326166604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- 2901016363 (MI)
- Practice address
- 1403 Birch St
Globe, AZ 85501-1328 - Phone
- (928) 812-6118
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121004000099 | TX | Order and Referring Only - Oral Surgery |
3072762210 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 2901016363 | MI | Yes |
Addresses
Primary practice location
1403 Birch St
Globe, AZ 85501-1328
Mailing address
1403 Birch
Globe, AS 85501
Phone (928) 812-6118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8045 | Medicaid | AK |
Other providers in Globe, AZ
- Ryan Bradley
- Ashley Bravo
- Todd Ray Brewster
- Mars Brimhall
- Robin Broz
- Stephanie Buerk
- Marcy Lee Burr
- Caaring Hands Assisted Living LLC
- Kenneth Cahall
- Jordan Call
All providers in Globe, AZ · Public Health Dentistry in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.