Individual provider Active NPI

Brandon Tyler James, DMD

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1336520832
Registry record updated Jun 11, 2015
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9584 Issued in KY
Practice address
911 Palatka Rd
Louisville, KY 40214-3461
Phone
(502) 366-2448
Fax
(502) 366-3551
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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 9584 KY Primary

Addresses

Primary practice location

911 Palatka Rd
Louisville, KY 40214-3461

Mailing address

911 Palatka Rd
Louisville, KY 40214-3461
Phone (502) 366-2448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20160617001905 KY Order and Referring Only - DentistPractitioner - Dentist 0840581039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9584KYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1336520832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 PALATKA RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402143461",
            "telephone_number": "502-366-2448",
            "fax_number": "502-366-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 PALATKA RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402143461",
            "telephone_number": "502-366-2448",
            "fax_number": "502-366-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "BRANDON",
        "middle_name": "TYLER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.